Headline news announced recently a Senate plan to modify and change certain aspects of funding our health care system. One of my U.S. Senators stated, “I have said from the beginning that I want to be a partner in making healthcare more affordable and accessible for our state….” The senator’s comments and the rest of the news stories then focused close attention to the effect the proposal will have on you and me, the consumers of healthcare services, as well as the insurance system that pays the providers of our services. Noticeably absent from the discussion is any mention of the providers themselves–the amount they charge and the profits they accrue from the system.
This absence should be disconcerting to us. If you are not alarmed, then maybe you should tour the parking spaces of your local hospital, comparing those reserved for physicians with those available to the masses–polished and gleaming German and British models for the physicians and beat-up trucks for the commoners.
Then walk into the hospital whose entry compares favorably with the lobby of a Ritz-Carleton hotel. If one is looking for a place to study the dichotomy between the “haves” and the “have-nots,” a hospital would be the perfect place to start.
One justification raised by the “haves” (the physicians) is that they are justly entitled to their financial reward after “suffering” through eight years of higher education and two to four years of residency. Lest we forget, seminary-trained ministers endure seven years of higher education and, in some denominations, three years of supervision before being ordained. But precious few ministers drive polished German and British cars. Ministers believe they are “called” to their positions of service. Are physicians, who swear their Hippocratic Oaths, likewise “called” to their positions of service to those in need of their healing arts?
The sense of “call” for health care providers should be elevated and recognized as a new public virtue by our community as we, the consumers of their services, insist on financial restraint in our collective payments to them. As the discussion about shifting the financial responsibility for paying our medical bills to consumers progresses, then we may want to begin by saying “No” to, for example, the freshly minted radiologist who expects a starting salary of $350,000 for services where (s)he rarely meets a patient.
We, as a community, can and should say “No.” The current healthcare system is beginning to resemble more a regulated utility than a business in common commerce. Like a utility, physicians’ pay is generally imposed upon us and is rarely negotiated directly between the physician and the patient, elective procedures being the exception. Utilities are required to disclose to regulators their operating costs and then propose a level of profit for regulators to consider. One of those regulators is a consumer advocate who can argue “No” on our behalf to the utilities. Unless and until physicians and hospitals want to negotiate with us directly, with transparency, in advance the charge for services, maybe we should regulate physicians’ pay by saying “No” to those who seek to enrich themselves at the expense of their patients–because of their “call to serve!”
Some may be concerned that imposing reduced physicians’ pay could result in them moving overseas, thereby leaving us without care. And this is precisely the concern many physicians and other providers want us to have in order to scare us into continuing to support their lucrative profession. Maybe we should call their bluff. Where are they going to go and make more?
Hopefully, my junk-food-for-thought may add something noticeably absent from the current discussion concerning our health care system. The rocks that Moses brought down from the mountain did not have carved upon them, “Thou shalt pay thy physician a boatload of money!”
Discussion on this issue was made clear in my recent one-hour exchange with a plumber. My pipes were clogged. The plumber gave me an estimate for his services, which I agreed was reasonable. Then, he cleared the clog, gave me a bill, and I paid it. Both he and I were satisfied. I wonder whether or not gastroenterologists, urologists and proctologists and their patients experience the same satisfaction.
I have purposely left off discussing pharmaceutical companies–the subject of a future “come-to-Jesus” piece. As a prelude, instead of mere cars, “big pharma” parking lots are littered with private jets and helicopters!
[J. William St. Clair lives in Huntington, West Virginia. He is a minister and, obviously, enjoys expressing his opinion on current affairs. This is his first article in Columnist with a View.]
Maybe it was the way I was raised. Maybe it was years of tight cash flow and different priorities, but I have never been a big television watcher. So, I often do not know much about the latest popular show and definitely do not get assaulted by a lot of commercials. Recently the games I play on my phone (Words with Friends and Sudoku) have started to run ads. Boo! But since that personal budget constraint makes me feel I have better things to do with $10 than pay to not have ads show.
So, I have been collecting slogans in the past couple of months. I know that the people who design ads are using words, pictures and sound to attract their assumed demographic for their products. I just do not think I fit many of those groupings. Here’s a small example:
PERFECT TODAY, BETTER TOMORROW. I don’t remember the concept being marketed but just looking at the words I think they missed it. What is better than perfect? If we have perfect today, why change? But since most of us do not have “perfect” I guess some people buy into a better tomorrow with whatever they were pushing.
LUXURY HAS NO BOUNDARIES. Again, I did not note the item being sold but this reminded me of something my family discussed twenty-two years ago. (I remember when because I was pregnant with Sam.) We were on a summer vacation (cabins, not camping because of my pregnancy) when the lottery had reached 80 million dollars. To kill time while we were driving we played the “what if we won” game. With three families in attachment, we bought everyone new houses, new cars, set up college funds for the kids and retirement funds for all the adults, went on several trips a year and believe it or not, by the seventh year we had run out of things to do and buy. BUT I reminded them that we, at this level of middle class, had really no idea how the wealthy spend their money. For example, wouldn’t it be more comfortable to hire a private jet to fly us to Europe than even taking first class on a scheduled airline? So I understand the concept that I don’t really know about acquiring luxuries. So exactly who is being targeted with this ad?
FAKE BUT ACCURATE. What? I certainly am not buying that news and information can be accurate if it is fake. So let’s play with the idea of eyelashes, hair color, fake fur. All perfectly acceptable, but would you use “accurate” to describe them?
DOUBLE MEANS DOUBLE. This was for a credit card marketing their earned points system. But come on. Single means single. Triple means triple. Horse means horse. Meaningless drivel is meaningless drivel.
TWO BUCKS IS BETTER. Really, McDonalds? What is better about $2.00? Oh, you are flashing photos of your various drinks with whipped cream. So, what are you trying to tell us? They used to be more expensive? They ARE more expensive elsewhere (like Starbucks) and you are implying the quality is the same? I have no idea. I just know that in the years McDonalds has been in business their prices have gone up, their serving sizes have gone down, and their food just doesn’t taste like the same thing I can fix at home…for less!
ENJOY THE GO. Charmin wants you to have a nice experience. LOL Here’s one that was not televised. I suppose we should be grateful.
So, just a small example of ones that I felt were not talking to me.
On the other hand, I have enjoyed AND WATCHED several video ads in full recently. Two were for Audible. One was a woman on a train and the other was an older dude sitting in a café. Both listening. Both absorbed. Startling back to reality with some intrusion. I recognize that feeling. I haven’t gotten an Audible subscription yet, but the next road trip I will.
I also clicked on an ad for an insulated bottle that holds a beer bottle. Now that product shows up in more ads on my internet feed. Love those cookies, eh?
The point is, ads work. Even for me, who is not a big shopper. In the past year I purchased socks that were advertised on Facebook (and love them) and a solar charger that looked like it would work well for my daughter and her dude who do a lot of back country exploring.
But who finds themselves heading to Micky D’s to get some pink stuff?
[Beth Rankin lives with her husband Graham in McMinnville, Oregon. She is a gifted entrepreneur, blogger, and writer. She is also the chief executive of Can-Do Foods. Beth’s articles are frequently reprinted in Columnist with a View from her blog “Going Places, Living Life.”]
The U.S. Senate is reportedly considering a healthcare bill, although few will admit to seeing it or knowing its contents. Rumors indicate it will not, as hoped, be a “kinder, gentler” version of the House bill. There’s been a great deal of criticism of the direct effects of the House bill including, but not limited to, tens of millions without insurance, astronomical cost increases for seniors and those with pre-existing conditions, inability to get coverage for preexisting conditions, watered-down coverage (with many standard situations not covered) and loss of support for those in nursing homes. However, I’ve heard little regarding the effects on those not included above.
Please note the following is not deeply researched, but largely the product of my own logical process and as such could be far from accurate. I’d love feedback from those more deeply-informed than I.
Let’s imagine an employed head of family with a spouse and two children. Insurance for this family is provided by his/her employer and deducted from his/her paycheck. In fact, both spouses enjoy this benefit, so if one loses his/her job, there’s a back-up plan. This happy family is probably laboring under the illusion that they have nothing to fear. I believe this is far from the truth!
The disappearance of billions of dollars from medical payments will impact clinics and hospitals. Personnel will be laid off and programs will be cut. Wait-time for all services will be longer and some “frills” will disappear. If you need a class on dealing with your child’s juvenile diabetes, for instance, it may no longer be offered as often or not at all. If it takes you a month to get an appointment with your doctor now, that wait may double. If you child falls off the playground equipment and breaks an arm, the emergency room visit may stretch to eight hours as opposed to four.
Ted Chan, founder of Care Dash, an online site for feedback on doctors, (yeah, I did some research!) was quoted in Becker’s Hospital Review on March 9, 2017, as saying:
“Repealing the Affordable Care Act (ACA) without clear guidelines for replacing coverage will drive up costs across the board for patients, employers, and hospitals. Without requiring all to be insured, hospitals will be the insurers of last resort and will absorb the costs of uninsured patients seeking care. One recent study found that half of hospital bills go unpaid and that will only likely increase without an individual mandate….
When hospital bills go unpaid, taxpayers and local governments are often forced to pick up the tab. The question is not whether healthcare coverage should be paid for, it’s who pays.”
If you live in a rural area, the impact may be even greater, as rural medical services are economically tenuous. With fewer patients to serve and more low-income individuals, tight budgets are a constant. Under the ACA, there were supposed to be provisions to help rural medical programs, but many of these provisions were revised or never implemented.
Our happy fictional family may find their medical costs increase despite their insured status. When a family isn’t insured, that doesn’t mean they don’t get sick! They do, however, wait longer to seek treatment, present as sicker when they do go to the doctor, and their treatment is therefore more expensive. Since the bill is less likely to be paid, the hospital must recoup as much as possible in the form of increased costs for those WITH insurance. When insurance companies pay more, they’re going to raise the cost of their policies. Our fictional family will pay in increased insurance costs.
People who don’t have insurance are more costly employees. Since they can’t afford preventive care, they’re more likely to be sicker and miss additional time at work. (I’d prefer they NOT work, since someone coughing over my fast-food order is not something I relish!) I suspect this was one original motivation for employer-sponsored healthcare coverage.
Therefore, Fictional Family will be affected directly by the proposed healthcare bill. The medical services they need may well become harder to access, their health insurance costs increase, and their communities become a less pleasant and welcoming place to live.
PERHAPS WE SHOULD BE SHARING THIS MESSAGE FOR THOSE WHO MISTAKENLY ASSUME THEY’LL NOT BE AFFECTED BY THIS [“REPEAL AND REPLACE”] LEGISLATION.
Deborah G. Hankins is a retired “worker” who lives with her husband Milt and their little chihuahua Jose in Ashland, Kentucky. She is a leader in the local “Indivisible” group and is seriously concerned about our future under the present administration.
[James Merritt is a master of short fiction. He is especially talented at weaving a story from almost any subject–from horror to humor. Following are four stories we think you’ll enjoy–or, at least get a “kick” out of!]
With each balloon that popped, his future died a little more. His dreams of hearing, changing, and expressing the world through music ending with each dart thrown. With the air escaping a million unknown futures falling behind him. Once he was a young child whose mother daily forced him to practice singing, violin, and piano.
When he turned twelve, he found his talents multiplying daily. On the same day his mother discovered heroin.
By fourteen, he simply had to escape the destruction of what was left of his home. He ran off to a carnival and worked, thinking he would only stay until he was old enough to escape as an adult. Working the balloon pop station for four years destroyed his hearing–ending what was the great hope of humanity. He had had the potential to put all other musicians past and present to shame. Potential to save humanity from war through the purest beauty in the universe. Now, humanity would be lost–the world’s destruction due to a balloon pop.
FLY AND HIS LOVER
The fly found its soulmate from its previous life and buzzed around his head. Landing on the human, he shared his coffee, lightly caressed his hand.
The fly was driving the man nuts! It was buzzing around his head, landing on his coffee cup, and crawling up and down his arm.
The man picked up the bright green tool of death and swatted the fly, not quite killing it with the first blow–realizing only after the first attack of his loves true form. So, he hit it again and again, destroying his love in hopes of it coming back in a more pleasant form. Perhaps they could be together in another life.
Huzzah! One less fly in the world.
Well below the deepest hidden basement of the forgotten Smithsonian lies a cavern filled with artifacts from distant galaxies–hidden there by those who do not want mankind to know of alien life.
In the darkest corner of the dusty cavern, lit by a single bulb, on a stand sits a pair of beautifully engraved leather shoes. Swirling over the old skin are flowers carved, mixed with maps of the infinite universe. These shoes outshine the most beautiful ever created.
The shoes found their way here after the death of their creator. The majestic shoes were created by an alien named Herschel. Herschel came from a distant world of creatures that look very much like me and you. A major difference is, in his world, each individual spends their life on a singular project–perfecting it to mastery. Herschel had traveled the stars in search of his medium–to create his life’s majesty. He crash landed on a roof in New York City and spent his short lifetime in the same building; although long for his species of five earth years. During this time he only befriended one person–an old Jewish leather worker named Takhash. Takhash taught Herschel his skill.
At the end of Herschel’s life, he presented the shoes to Takhash who discovered, unlike humans, Herschel and his people had hooves instead of feet. As Herschel had only seen people with shoes on, he assumed they were just a strange earth-style. Due to this, his one-of- a-kind shoes insides were made for a hoof.
The next day, Takhash found Herschel dead outside his door. When he called the police, men in black came and took the body and shoes away. After being studied, the shoes were hidden away from humanity. The glorious work of Hershel’s existence were never against seen by the living, but by spiders and dust mites. When the earth’s end came in the final moments, the spirits of the earth sought out the most beautiful sights. The earth itself paused its shakes and volcanoes for a moment in awe of a pair of beautiful, intricately-designed shoes.
He woke screaming from his nightmare, and realizing it was only a dream, got out of bed. He went to his kitchen–being extra quiet so the monsters did not hear him. The giant flying monster killed his mom, and his father was shot and killed, leaving him alone in the high rise with all of his noisy neighbors. He grabbed a handful of nuts and found a comfortable seat while he chewed his morning dinner.
All of a sudden his house shook, and he knew it was the end when he heard timber as the terrorist monsters toppled the high rise, not even giving warning to evacuate. As he tumbled and fell to the ground, the smash of his home hitting the ground was deafening. Hobbling outside on his broken leg he looked up at the monsters just in time to see the forest descend on the beasts.
The flying monsters attacked their eyes while spiders bit any uncovered skin. He crawled up a leg of the thing and bit it where its legs came together. The thing let out a piercing scream as a bear came in and clawed out its throat. When other forests lost their spirit protectors they became fearful of the two-legged monsters. Not this forest, for the creatures in it were trained to kill. When left alone, they only killed each other for meat, but when a man-beast entered they never left alive. The entire crew of monsters were dead within minutes, their bodies devoured within two days and their metal buried with berry bushes planted on top.
Next time you need a tree, ask its inhabitants first. Make sure to give thirty days notice of eviction; otherwise, your nuts may become chips!
[James Merritt lives in Maryland. He is a teacher, entrepreneur, story-teller and writer. We are pleased to have published several of James’s stories in Columnist with a View, so you can search the Archives for other short-shorts. He has published a small collection which is available on Amazon.com.]