Saturday, December 22, 2007

Medical Care & Health Insurance

I should the last person to criticize the current state of medical care and health insurance. I've had 10 orthopedic surgeries over the past 40 years and they've all been taken care of with very little out of pocket expense on my part. I've been fortunate to have been covered by some type of insurance at a reasonable cost. For the past 8 years my health insurance premium has been paid for by my employer.

But something is very wrong with the overall system: I see a couple of issues

LOTS OF PEOPLE UNINSURED
Estimates vary but there are probably about 40 million people in America who have no medical insurance. Some of them are young folks no longer covered under their parents, others are unemployed between jobs, some are those with a serious medical problem which emerged while they were uninsured, etc. While some of these folks go without coverage for a short time, some of them remain uninsured for a long time. Unfortunately illness and accidents strike enough of this group to put a strain on the overall system and/or let people do without.

RELYING ON EMPLOYERS TO OBTAIN INSURANCE
Many Americans are covered by group plans through companies. This works for those employed by companies who offer(and sometimes subsidize plans). Insurance can become real expensive for the self employed and employees who change or leave jobs. It may not be possible to continue when a person changes jobs with a medical condition--of course no one ever changes jobs or has a medical condition--right!

RELYING ON GOVERNMENT TO SOLVE A FREE MARKET ISSUE
I believe this would be disastrous. Except for the Constitution and the interstate highway system I can't think of anything the government has done more efficiently than the free market system. Think I'm wrong--audit the post office and social security for starters. The only role government should play is offering tax incentives and designing transportation systems that provide alternatives that promote wellness, i.e. sidewalks, room for bikes on roads, etc.

MEDICAL CARE IS A PAPER, SCISSORS, STONE, GAME
Insured patients don't shop for medical services because they don't pay directly. Doctors, hospitals and other providers inflate charges because they know insurance companies with large groups will beat them down. Insurance companies have large numbers and money. Each group seems to work on their own to win without regard to other components. Uninsured patients either go without treatment and/or pass their costs onto society.


WHAT DO I RECOMMEND?
1. Create Individual Health Savings Accounts. All funds deposited are tax deductible for contributor. No limits--if an individual sets aside $1,000,000 that's fine--if they set aside $100 that's OK too. Contributions can come from anywhere, i.e. individual, friend, family, company whatever. HSAs can be established for anyone, anytime and funds can only be used for medical/health care costs. Funds in an individual account can be transferred to a designated beneficiary upon death.

2. Let existing insurance plans continue that work for groups and/or individuals.

3. Eliminate expiration date for Cobra. If someone leaves employer sponsored program they can continue coverage as long as they pay premium.

4. Push for incentives that benefit individuals, doctors, hospitals, and insurance companies. This topic warrants a separate post--stay tuned.

Tuesday, December 18, 2007

Rebuttal To My Brother

My brother Mark recently posted an article, Convenient Targets on his blog http://www.unsolicitedopinion.blogspot.com/ For my perspective read an earlier post of mine, Mexican Standoff. I visit Mark's site regularly because he writes well, posts often, and I respect his political savy. Even though sharing the same genes we don't think alike on many issues, but you can tell we're brothers. This article is a good illustration of our similarities and differences.

Mark expresses the opinion that corporations seek to lower costs and maximize profit without regard to social progress. I believe in a free market where every individual seeks to get the maxium return for their effort (wages) and spend the least amount possible for goods and services. When it comes down to illegal immigrants it's not corporations (big business) that hires these folks--it's the lettuce growers in Yuma who can't find an American willing to pick crops combined with other Americans who won't pay for Americans to pick lettuce when someone else will do it for a fraction of the harvest cost. It's the contractor re-roofing a house where the homeowner gets 4 bids ranging from $1,500 to $6,000. I could go one but you get the point--and certainly other factors (insurance, taxes, etc) influence this.

Mark has a valid point about the balance between profit and social progress. The issue I have is the dependency on government to measure, monitor, and deliver. I trust government about as much as Mark trusts corporations. There are lots of wealthy corporate officers (Greenburg, Welch) who have profited at others' expense, but there are plenty of politicians (Clintons, Bush) who have done the same thing in a different arena. I live in Atlanta and have watched the 40+ year neglect over our sewer system now being addressed with torn up streets and massive amounts of money changing hands under government tables. It's big business AND government seeking their self interests, and I dont trust either one. The best way to fix something like this is for citizens to become much more concerned about their local and state goverments instead of worrying so much about national politics, but I'm getting off the subject here.

Many Mexicans see more opportunity here in America. How do we change that? Mark's post doesn't offer a concrete solution. The simple answer is we annex Mexico and make it the 51st state. Save a lot of money on border security--perhaps set up toll booths and generate even more revenue. Of course Mexican politicians and corporations may not like this, but I don't care--invading and annexing Mexico is a lot less expensive than all the "social progress" we're paying for in Iraq--probably even less loss of life than when Pancho Villa tried to annex Texas. And it's a damn site closer to home.

Mark points that migration has been a key to opportunity throughout history. I agree and in a perfect world there shouldn't be any lines or barriers. One problem is there are people on this planet who want to terrorize and kill others just because. I would rather see the United States spend less resources on "illegal immigrants" and devote them to reducing the risks presented by those who want to harm us either here or from abroad.

Like Mark, I don't have a concrete answer yet. But the sooner we as a nation recognize we can't solve all the planet's issues the closer we may get to prioritizing and dealing with our own. And isn't that how a free market system is suppose to work?

Sunday, June 17, 2007

Father's Day--2007

Today is father's day and my father's birthday. Last year on this date I posted a refection on him. Today I went on a bike ride. It's a ride I've done before over 3 gaps in north Georgia, but I hadn't been over these 3 since my knee replacements. As our mostly male group started we wished each other a happy father's day. I remembered it was also my father's birthday.

The ride was hard but certainly less painful with new knees. I rode alone most of the ride--couldn't follow my younger friends up the early steep hills but went off the front for a long time after they stopped to fix a flat. I thought of my father a few times during the ride. I remember thinking I never rode a bike with him even though I've ridden since I was 5. My goal was to climb Hog pen without stopping and I made it.

I checked my brother Mark's site and today he posted his reflections on our father. He did a through hike on the Appalachian Trial 5 years ago and thought about our father often. His post was from his memoirs. Today my ride crossed the AT twice and my drive to and from the ride crossed the AT twice. Funny how brothers have similar thoughts in similar places years apart.

Wednesday, May 23, 2007

My Dogs

My brother Mark recently posted reflections on his 15 year relationship with his dog Prince. I have posted articles about my last 2 dogs Greta & Shadow. While those 2 are the most recent relationships I've had with dogs there have been others.


As a 8 year old I wanted a dog. My father had told me about the wire haired fox terriers he had who chased rats that invaded his drug store in Shippensburg. One day I came home and found dog food in our kitchen. He had gotten a wire haired fox terrier for the family. We named her Wimpy because she loved hamburger (like the Popeye character). She was a pure bred and my father bred her so we had a litter of puppies. Watching that whole process was fascinating to me. Even when the pups were sent to a vet for sale I would ride my bike there to check on them. Wimpy though was mainly my father's dog. When he died she seemed lost. When my mother was hospitalized with a nervous breakdown Mark and I were sent to Johnstown. We were told Wimpy died, but I think she was put down while we were gone.


9 years later a girl (Sarah)I was dating convinced me I needed a dog. I told her I wanted a male wire haired fox terrier so she got me one. I named him Topper after the TV series. He was a good dog, but 6 months into his life he was killed. I felt guilty for letting him run loose but all we were doing was walking to my car--he was excited and jumped into the street right in front of a car. I buried Topper in Sarah's back yard and she immediately got me another fox terrier. I named him Bo after the song Mr Bojangles (after 20 years he still grieved). I had Bo from 1972 until 1988. He was a unusual dog--independent, never expressed pain even though surviving a raccoon fight, a run in with barbed wire, and hanging himself off a deck while on a leash. Not very affectionate though. he fell down stairs when he was about one year old and I think he was never really affectionate after that incident.


I inherited a dog when I married Pam named Loretta (after her mother). Bo and Loretta were with me about 11 years. Loretta was more affectionate than Bo. Both of them would wander whenever they got loose and not come back for hours. When I moved to Atlanta in 1982 Bo dug under the fence and was gone several days. I figured he was gone forever since he didn't have an Atlanta dog tag but some one found him and called animal control. Five years later while I was on vacation a service person left a gate open and both dogs got loose. The person house sitting found them, but a day later Loretta became sick and died at the vet's office. I later discovered another neighbor's dog was loose the same day and died--an autopsy revealed food poisoning. Apparently some one decided there were too many dogs on the loose and fed them something fatal.


In 1988 my wife Nancy wanted to get Jeff a dog. Bo was 16 years old and fading. That's when Shadow entered my life. Even though Shadow was suppose to be Jeff's dog she attached herself to me. Shadow was around almost 14 years through some pretty tough times for me. But she was my most faithful companion. See previous post Papa's Little Girl that I wrote 3 years after she was gone.


I currently have Greta, an Aussie Shepherd/Beagle mix. I got her a month after Shadow's passing. Greta has characteristics of my previous dogs. She wanders a bit like Bo and Loretta but always comes back. Fortunately she is very street smart and doesn't go into the street. She is affectionate like Shadow. However, unlike Shadow, sometimes she just won't do what I want her to do. Greta has one obsession though--she wants to chase a tennis ball forever. And once she starts chasing a particular ball that is the only one she will retrieve. Hopefully we have another 10+ years together.



During my 61 years I' ve had a dog(s) for about 42 of those years. Since my first dog I've only been dog less about 9 years (college & early business career). It would be hard to imagine not having a dog in my life. While Shadow was probably the best dog I've had so far, I grieved and mourned each one when they died. I hope I'm around long enough to mourn a few more.

Monday, April 23, 2007

My Mother's Birthday

Today's my Mother's 92nd birthday. I wish she had been around to celebrate more than the 64 she lived. So far that's 3 more than me. I was 33 when she died so I was around her twice as long as my father. It's hard for me to decide which one I was closer too--it seems like I wasn't close to either one--but that's probably me thinking about the distance I maintain with everyone.

Katherine Marcella Pie was born April 23, 1915. She grew up in a family of 9 children. From everything her siblings told me (and my own observations) she was the brightest and smartest. She kept copies of letters she wrote from 1938--1948 to a friend. I first saw them a few years ago and they are so revealing. In fact that's one reason I created this site--it reveals more of me than I would ever share in public.

Anyway she was a gifted writer, and that talent is one she passed on to me and my brother. She wrote 2 novels, she could sew and knit, but I think her most endearing quality was the love and devotion she bestowed on my father. This wasn't obvious to me at the time, but looking back things sometimes get clear. When he died in 1962 she was devastated. She suffered 2 mental breakdowns over the next year--one of which institutionalized her for about 5 months.



From then until she died it seemed to me that she just didn't care about life any more. It was painful for me to watch, not able to really help her in any way that changed things. Looking back I just gave up and moved on with my life. I've done that since in 2 marriages--not knowing how to connect then giving up and moving on. But in reflections with my brother Mark we don't seem to come up with anything we could have done to help our mother move on after the death of our father.



Looking back on her life though I think there was a 3 year period from 1963--66 where she helped Mark and I develop. That was my last year of high school and first years at college. Mark was 2 years behind me. During that time she re-obtained her nursing credentials and worked at the hospital. During those years there was enough stability and financial assistance so Mark and I could go on to college. Right after my father died I was told there wasn't enough money for either one of us to go anywhere after high school except to work. I think my mother pushed herself so we could further our education somewhere--she knew there was potential and she wanted to jump start it for both of us.



I think my mother showed us the way to get up and start flying on our own during those years. Something happened at the hospital in 1966 where she was accused of doing something incorrectly and after that she never worked again. Instead the long downward spiral started again and didn't end until she died on June 24, 1979.



So, Mother here's to you on your 94th birthday. Like I said in my fathers post on his 100th, I wish we could have celebrated more of them in person. And I also wish the two of you could have had more than 16 years of marriage.

Thursday, April 19, 2007

God--Where Are You?

The massacre at Virginia Tech makes me wonder--again--is there really a God the way most religions portray him? How could an almighty being create a person who then destroys32 people who were productive members of society? Of course it's not the first time this has happened. From folks like Adolph Hitler through Charles Whitman thousands of evil or fucked up humans have destroyed others who did not deserve to die.

I cannot imagine a God in heaven (wherever) being all loving, all forgiving and almighty creating that kind of havoc. Instead I believe in the laws of nature: lots of things happen just because. People die because of illness, accidents, war, violence, etc. Over the course of history many bad ass people have done a lot of evil stuff. I've had my share of illness, I've driven and cycled thousands of miles, I've sat in class rooms, restaurants, and many other places where accidents or violent acts could have occurred. I've had my share of surgeries and accidents where something could have gone wrong and killed me.

Why have I lived 61 years while others have not? I have no idea. I don't think it's because some almighty being is "looking after me". And what will happen when I die? While it would be nice to think there's some place like heaven, I think I'll turn into dust/compost while the natural world goes on. I'm not trying to convince anyone there isn't a God; I just don't think anyone can convince me there is.

Wednesday, January 10, 2007

Team Alabama

IN TRIBUTE TO ALICIA JOHNSON ON THE EVE OF HER MOVE BACK TO COLORADO

On Saturday morning April 30, 2005 our TNT cycling team met in Warm Springs for a 60+ mile ride. As most of us drove south from Atlanta we had to negotiate a huge rain storm that showed no signs of stopping and the breaking early morning news that the "missing bride" had been located in New Mexico after being kidnapped by illegal aliens--I mean immigrants--I mean maybe they were legal--who cares. She turned out to be the "runaway bride" and it looks like that's as close as Alicia might get to the term bride--but forgive my digression.

We gathered at the Best Western for a 10:00 ride start, but no one--myself included wanted to start in the downpour. Since most of us had hotel reservations for that night with plans for a cookout we didn't want to call it quits. By about 12:30 a few folks who weren't planning on staying had abandoned us, but the rain had stopped and the weather was marginally OK--at least that's what I decided, and since I was the head coach the mantra was "Are you riding--or are you hiding?'

Some folks wondered about the climb from downtown Warm Springs to the Best Western because it was 1 mile long and 10% grade. I told them it was the hardest hill--maybe I said the only hill--but once that's done the ride is over. Some may say that's the closet truthful description and/or the biggest lie I've ever told about hills on a ride.

Except for the weather getting better I don't remember much about the ride, but by late afternoon all cyclists were back except Alicia, Jane, Harold and Kim. No one had seen them in quite a while. Some folks speculated they turned around and gone back to the hotel (that proved to be factual). But their rooms were empty and we could not reach them on those things they call cell phones.

The front desk attendant told us one of them called to report they had gotten lost but were on their way back to the hotel. We tried to call them to figure out exactly where they were, but couldn't reach them. To make sure they had enough fluids and food, I drove our route in reverse to find them while others went to he grocery store to get food for the cookout. I was kinda glad to be searching cause I don't like to grocery shop especially buying stuff for others. I drove about 20 miles (almost one third of the route) but didn't see them. Called the hotel and still no sign of them. I drove back to the hotel following the route positive I would find them. No such luck--so I did a "Mount Everest" to save myself since I was pretty damn hungry.

Alicia and her comrades finally showed up. Turns out they missed the second frigging turn on our route. They finally figured out they were lost when they got close the Alabama state line--like a trillion miles off course. But they didn't stop there. Despite a warning from one of the locals "GO BACK, GO BACK!" they cycled to the Alabama state line. I have a T shirt with evidence. Only then did they decide to GO BACK and it was even later before they called the hotel.

But why didn't they tell anyone where they were--or where they weren't, either on course or off course? The answer of course is because they are TEAM ALABAMA! The other speculation is they did not want to climb the hill out of Warm Springs.

Coach Neil

P.S. Recently I was riding with Pete Smith--Alicia's candy ass (surrogate boy friend). We talked about Alicia's upcoming surprise party and what appropriate memories we could put in her scrap book. Pete laughed but then said "You know out of 4.5 million people in Atlanta who could move, I'm going to miss Alicia the most."

DITTO FROM ME AND ALL YOUR ATLANTA FRIENDS.