Friday, July 31, 2009

A Poem

I've often been entertained and enlightened by poems posted by my friend ThomasLB. To say "thank you", I'm offering a short poem by Li Shangyin, a Chinese poet of the late Tang dynasty.

Sometimes, parting is more open ended than we would like it to be.

"You ask me when I will return.
The time is not yet known.
Night rain overspills the autumn pools
on Ba Shan Mountain.
When shall we trim a candle at the western window
And speak of this night's mountain rain?"

"Big" is Different from "Fat"

This week I've been treated to two radio experiences dealing with "fat". Both had to do with social clubs that cater to "plus size" people and other people who like to be with them. Since 25% of the U.S. population is now officially obese, I guess it's time that some folks realized they represent more of a business opportunity than just extra large clothing. And being "fat" doesn't mean being poor; large people also can make good money and spend it, too. But some of the propaganda being put out by these folks is downright dangerous, because there is a very important difference between being "big" and being "fat" (obese).

One can be big and heavy without being "fat". Lots of pro football players are living proof of this; their percentages of body fat are lower than many people who look "skinny". Genetics have everything to do with body shape, and some people have big bones and bulky body shapes. Good for them! If they stay in reasonable shape they will have nice low blood pressures and pulses, avoid diabetes, and expect a normal life span. They can even go to these clubs that cater to big people, if they choose.

But it really dismayed me to hear a woman say, straight out, that it's OK to be obese...that it's wrong to criticize people for being obese. She was one of these fat people who so oppose the stigma that fat people often endure that she's gone off the deep end of acceptance. Fortunately, the interviewer on NPR had the guts to challenge her position. She came back with the argument that people can be big and heavy, without being fat - which is true. But she would not admit that obesity is a serious health problem or that she was trying to rationalize it away.

Why do I care? I'm not fat, none of my relatives are fat, and few of my friends and acquaintances are obese. That is primarily because I came from an upper middle class home and live in an upper middle class area where most people are health-conscious. But I care because I've seen, close up as an EMT, the terrible toll that obesity takes on a human being. And, I care because obesity is an extremely expensive problem for our country as a whole.

Obesity is a major cause of disability in younger people. How many very heavy younger people do you see limping? Their knees and hips are being destroyed by weight their body was not meant to carry, and by middle age they will be tooling around in power chairs. Their weight also puts a huge strain on their cardiovascular system; they sweat even in average temperatures, and they get short of breath with minimal exertion. They are likely to get type 2 diabetes, which attacks multiple organs and may well result in severe circulatory problems and even amputation. These issues make them far less able to live normally and often shorten their lives. Lastly, their disability payments and obesity-related medical costs are, in total, a truly giant sum that society pays.

It's true that most of us lead lives that are unhealthy in one respect or another. I smoked cigarettes for many years, for example. Others of us are too sedentary or perhaps even skinny to the point of emaciation. But, to be honest, there is no common voluntary behavior that has anywhere near the total negative health affects as does obesity. As a culture, we need to "reduce it". Alot. Making obesity seem OK is just plain wrong and dangerous.

Don't get me wrong. I feel badly for people who put on pounds fast and have a hard time getting them off. Their situation may well be genetic or socially-determined, and it's not fair to laugh at the mental and phyical struggles obese persons may face every day. We've just got to do everything we can to help these folks take off the weight and get in shape, just like we try to help people quit smoking and get in shape. And, we all can be nice about it.

Tuesday, July 28, 2009

I'm a "Blue Dog"

If you follow this humble blog, you know that I'm a big fan of health care reform. Our entire health care system is too costly, not as effective as it should be, and it leaves out too many people. Obama is right - the worse case is to continue with the system we have now. But, that said, we need to reform it in the right way.

Few proponents of health care reform want to talk about the approximately $35 trillion hole in Medicare. That's the difference between likely spending for those now living and projected receipts for the program during their lives. There's no way we can absorb this huge deficit within the federal budget, so something's got to give. Either we increase taxes and/or co-payments and/or premiums, or we reduce benefits. One thing we can't do is increase the Medicare deficit, but the current house bill does just that. It's a non-starter with me.

The "blue dog democrats" are holding Obama to his pledge that health care reform not add to the deficit. Good for them! Their opponents, the progressive democrats, want universal coverage and they don't care what they have to spend (or borrow) to get it. I heard one of them say today, "We are the richest country in the world - why can't we cover everyone?" Well, we could cover everyone, but we need to pay for it.

If we can't get a revenue-neutral or revenue-positive plan, I'd not be in favor of it. If I was Obama, I'd veto a deficit-creating plan and wait it out. Soon, so many Americans will be without health care or paying so much under the current system that a universal single-payer system will likely get the necessary votes from a new congress. But the blue dogs should still get their way.

As far as dealing with those who don't want the government to be in charge of their health care, I think they should be allowed to buy a health care policy on top of the best (most expensive) single payer plan. If they want premium care, they can pay extra for it. But, everyone else would be covered, too.

An addendum: If you think everyone with good insurance is treated the same by hospitals, you are mistaken. The rich, in addition to having blue chip insurance, often guarantee VIP treatment at hospitals by making donations to their capital campaigns. As an EMT, I've often seen these folks quietly moved to the head of the line. They expect it, and they get it. After all, they paid for it. This will never change, regardless of whatever we do with the national health care plan.

Monday, July 27, 2009

Assisted Suicide: A Human Right

In this week's Time Magazine, Nancy Gibbs presented an essay entitled, "Dying Together." The subtitle was, "An elderly British couple's suicide pact is a beautifully romantic act - and a troubling one." It's not troubling to me.

The husband was 85, a former conductor of Britain's Royal Opera. His eyesight was almost gone and his hearing was weak. His wife, 74, a former ballerina, had terminal liver and pancreatic cancer. They went to Zurich where, for $7,000 each, they were given beds next to each other and two small doses of clear liquid. They drank the barbiturate, lay down to sleep, and died within minutes. Legally.

Ms. Gibbs transitoned from this poignant story to describe the viewpoint of euthanasia activists like Ludwig Minelli, who believes that every human should have the right to end their own lives regardless of their physical or mental condition. She compares this viewpoint with that of those who believe every life is precious, to the point of preventing suicide regardless of whatever reason one might want to do it.

Then comes the punch line. Obama apparently said, "those toward the end of their lives are accounting for potentially 80% of the total health care bill." (I've been writing about this lately in other posts.) Gibbs is concerned that "the right to die might become a duty to die." This is the old "slippery slope" argument - give them an inch and soon they'll take a mile. She cites examples where aged parents chose suicide in order to remove an economic burden from their children, and she concludes, "Advances in palliative care mean that those last years of life do not have to be a moral, medical, and financial nightmare."

I disagree. I have known several individuals whose lives became so restricted or painful that they chose to end their lives by suicide. In the case of Sir Edward Downes, life without the other and without faculties was too much to bear. His wife simply chose to avoid unnecessary agony. I don't see their pact as romantic; I see it as practical. Others are free to make totally opposite decisions, to choose lives of semi-vegetativeness or cruel pain to the end; Gibbs would call this latter choice "palliative care".

It seems to me that the modern world is allowing less and less autonomy for citizens. What could be more basic to autonomy than the choice of whether or not to live your own life? Sane persons who are not being coerced should have the right to check out on their own schedule. But, believe me, the thought has not crossed my mind. I'm having too much fun on this side of the curtain.

Go, Michael Vick!

He did the crime, he did the time. In America, when you get out of jail, you get to start anew. I suppose it makes sense for his former employer, the NFL, to put some oversight on him in order to avoid further embarassment, but Michael Vick deserves a second chance.

I just heard some sweet ladies comment to CNN that Michael's deeds make him forever a pariah in their minds. They think he should forever sweep streets, clean toilets, or some such thing because his crime was so heinous. Must be PETA members...

Michael Vick came from nowhere and was treated like a GOD who could do no wrong, whose wishes would all be fulfilled by his sycophants, and who earned a king's ransom for running and throwing a football. We forgot that he came from nowhere, where dogfighting is a manly sport. But he didn't forget, and he did what came naturally. Now he's paid the price, a very big price. It's time to see if he can remake himself and again do well in a very challenging occupation.

Go, Michael Vick! If you can become just an average guy, that would be a victory.

Friday, July 24, 2009

Obama Boots It, in Public

I tuned in to watch Obama's press conference on health care the other night. Although he can be a bit wordy, I thought he did a pretty good job of making his case on heath care. Of course, I'm an easy audience since I'm already convinced.

Then came the question involving professor Gates. Obama started his answer with two appropriate comments: first, that Gates is a friend of his; and second, that Obama does not know all the facts. Then, Obama boots it! Even though he had already stated he didn't know all the facts, he said the police officer "acted stupidly". This was an out and out "guilty" judgment, handed out by the president of the United States. Not a good idea at all.

Obama has been extremely diplomatic and non-reactive in so many situations, but he failed in this one. It cannot help but hurt him.

Thursday, July 23, 2009

Mayors, Rabbi's, and Low Politicians: Criminals!

It's not just Wall St. MBA's and attorneys who are willing to sell their souls for lot of bucks. It's Joey, David, Sally, and Mike, too - people who live just down the street and enjoy positions of local authority. These are among the 44 (so far) folks rolled up in the latest New Jersey & New York corruption bust. If convicted, they should join Madoff in federal prison for a long stay.

I'm sick of the immorality, the absent ethics, and the chutzpah of people like these clowns. They are not people who came from the lawless slums; they are people who understand exactly the risks they are taking and who they are defrauding. Put the guilty in the slammer and throw the key away!

Violent crime is scary and so painful, but white collar crime attacks the code which educated and "civilized" people are expected to live by, the underlying fabric of our society. It's time to ramp up the sentences and public condemnation for crimes committed by the privileged.

Tuesday, July 21, 2009

Gates Incident "Just one of those things."

NPR is all over the story of Harvard professor Henry Louis Gates Jr.'s arrest for disorderly conduct in his own home. Police were called to the scene when someone reported two black men were breaking into the home. Actually, Gates had come home from a trip, found the door stuck, and opened it with a tool. The police found him inside, asked for identification and perhaps checked it out. At some point during this process Gates became angry and was arrested. Now the black community is up in arms and every story of police overstepping their bounds is coming out. Sorry. I don't buy it. The incident is just one of those things.

Years ago I came home late at night when I was not expected. My wife did not answer the door bell, so I fumbled around to find a hidden key and let myself in. When I arrived at the top of the stairs, I heard my wife crying and looked into the bedroom. She was on the phone with the police! Her next words were, "O damn! It's my husband!"

Although the Good Witch tried to cancel the cops, a cop showed up in just a minute or two. I opened the door and let him in. He was not friendly. In fact, despite my wife's attestations, I had to prove I lived there and she had to talk to him separately and convince him that I was not holding any threat over her. The officer was very, very careful to make sure I was on the level before he would leave our home. In fact, his conduct seemed really intrusive at the time. By the next day, however, I realized that everything he did was aimed at making sure the Good Witch was safe. (However, I wasn't safe from her for a few days!)

From what I heard, Gates went through roughly the same experience I went through. It was pretty exasperating for me to have to prove myself in my own home, but I put up with it. Gates, who claimed he was very tired after a long trip, did not put up with it. I feel badly for him, but the incident was "just one of those things" - a cop trying to do his job right, and a citizen getting upset about it.

I'd be the last person to deny that black citizens get mistreated or hustled by cops. I'd also not deny that cops get a lot of crap from some black citizens. I just don't think that this incident was mistreatment. It was just one of those crazy things that happens once in awhile.

Saturday, July 18, 2009

It's the Big One!

Yes, I'm officially "old"; 65 years old today, that is. The U.S. government has taken over responsibility for my health care, the Good Witch tells me that every single hair on my head is white, I have a grandson in Iraq, and my little grandchildren send me a "Happy Birthday" video on Facebook. I may be old, but life is good. If I had to enumerate all the reasons why I'm one very happy guy, Blogspot would run out of storage space!

Suffice it to say that I have a loving wife, family and friends. I have a nice place to sleep and good food on the table. I can work hard for others and myself, and I can play hard - on the Appalachian Trail and the golf course. My hurts don't slow me down too much, and I keep my brain very busy. I trust God to forgive all my many flaws, but I'm also intentional about emulating Christ when my better side is in control. If today was my last day, I'd say I was blessed.

My dad (a man worth a book of his own) had the misfortune of contracting rheumatic fever as a child, and he died of heart failure at 63. At this point in my life, I consider every year to be a bonus year, and I remember him fondly.

Friday, July 17, 2009

The Economics of Health Care

In 1983, as part of my executive MBA at the University of Rochester, a senior economics professor explained how the dollars associated with health care were spent. He said, "On average, 90% of all health care dollars are expended on patients in their last year of life, and, of those dollars, 90% are spent in the last month of life". He then made the point that millions of American children had no preventive medical or dental care because our system provided no way to pay for it. This was an example of "allocation of resources" - it is what it is, and you make the value judgment.

Things have changed since 1983, so perhaps the spending happens a bit earlier than it did then. Drugs, for example, are far more numerous now than then, and they are not cheap. Also, many people are getting knee or hip replacements, or heart surgery, or other life-extending procedures that were not available 26 years ago. Yet I'd bet that a large percentage of U.S. health care costs continue to be incurred in the last year and month of the average patient's life.

With health care now costing America close to 15% of our gross national product, with estimates that it could go as high as 25% as our population continues to age and more and more costly treatments are developed, many analysts are convinced that our economy would collapse if this burden rate comes to pass. Costs must be reduced, and this one of the two primary reasons why President Obama is so focused on health care - the other reason being that many millions of Americans, including my 49 year old unemployed son, have no health insurance.

Most Americans support the idea of everyone having health insurance, and they subscribe to the idea that total costs must be reduced. But few Americans like the idea of rationing health care for terminally ill people. Consequently, we will continue to spend enormous sums to care for people who will die without benefitting much or at all from the care. Sooner or later this practice will have to change, simply because we will not be able to afford it. But, nobody in power is willing to open the discussion.

I feel the same way now as I did in 1983. Even the best life has a natural end. For those whose ends are long, often painful, and even semi-vegitative, hospice care should be the standard and costly, usually futile medical interventions should be prohibited. The savings should first be put toward giving every child the medical and dental care they need. If I'm the one who faces a lingering end, I'll choose to go the inexpensive way, with my family at my side. It's just better for all concerned.

Friday, July 10, 2009

The Christian Approach to Health Care

I've got to speak out for Christians and against Christians regarding the idea of making sure every American has access to a reasonable amount of health care.

Before we get to the Christian part, I want to define what I mean by "a reasonable amount of health care". I mean that every kid should have access to a child-trained internist or pediatrician, and a dentist, and that whatever preventive care they need will be covered. I also mean that if anyone gets severely injured or becomes seriously ill, the health care system will treat them without sending them a bill beyond a reasonable co-payment. But, there should be some limits to care; for example, defining when people are terminal and stopping useless care, and defining when continuing health problems are self-inflicted and requiring patient compliance in order to receive continuing care. I don't mind a little "tough love". Enough said about that.

Some Christians really believe in "do unto others as you would have them do unto you", and "love your neighbor as yourself". They understand that health care is a basic human need like food and shelter. If you don't have it, really bad things often happen. You lose your teeth; you may get preventable diseases that can wreck your life; life-threatening conditions aren't diagnosed promptly, etc. Real Christians put themselves in the position of fellow Americans and their children who can't afford health care, and they understand that the current system is wrong, even un-Christian. They consider the consequences if their own children had no dental care, for example, and they can't believe that other people's children should be in this position. These Christians will support any reasonable plan that will result in everyone having access to health care, even if they have to pay more to ensure all are covered.

Other self-described Christians don't agree that health care comes under the rubric of a basic human need. They may view those who don't have it as unworthy and lazy, having not worked hard enough to buy insurance or get it from their employer. Or, they may view those who don't have health care as "the poor, who will always be with us" - too bad, so sad. Or, they may simply admit they don't want to pay for someone else's health care because they need all their money for themselves. I know Christians who espouse each of the above points of view, both average people and politicians.

Well, at the end of the day the health care debate is all about money. Some Christians value the health and welfare of their fellow men, women and children over money. Some Christians value getting or keeping their own money over providing for the health and welfare of others who, mostly by accident of birth and opportunities, lack the resources to pay for medical care. If Jesus happened to drop by, which of these would he recognize?

Friday, July 03, 2009

Sarah Palin to Resign?

Apparently Sarah Palin has given two weeks notice in her current job as governor of Alaska. It's all about money.

Sarah couldn't win a national race for dogcatcher, but she has enough (dimwitted) fervent conservative followers to make her a very rich woman. In true republican tradition, she will max out on speaking fees until everyone realizes she's a no-show. We'll be seeing a lot of her on Faux News, mostly shilling for her next appearance in Dodo Land.

I have to confess I'm still a republican; I just can't find any republican candidates who I like. So, it's not that Sarah's a republican that I mock her; it's because she purports to be a republican when she's really a dodo. Republicans are educated and smart, or at least they used to be.

Maybe Sarah maybe thinks she can be president if the entire South secedes. But, I doubt it. When it comes to politics, she's a baby compared to those grizzed old southern racist non-veteran politicians. But, she's a babe, no doubt.

Wednesday, July 01, 2009


Come Saturday morning the Good Witch and I will hit the road for almost two weeks while son #1 holds down the home front.

We'll start in south central Kentucky, where many years ago I met my wife-to-be in the officer's club at Fort Campbell. She's the oldest of eight kids, most of whom still live near Hopkinsville. I really enjoy visiting with this large family . They're good, hard-working people, the home-cooked food is great although a bit too plentiful, and I know a good golf course not far from where we'll be staying. Once upon a time I was the Yankee who stole the girl for a marriage that would never last, but after 43 years the family has figured out I'm OK. To give you an idea of how different it is down there, a wild peacock often flies up to the cupola of her sister's country home, just to have a look around!

Then on to the Tri-Cities area, to Johnson City, Tennessee. My next younger brother is now retired there on a large piece of property where he wears himself out doing major agricultural and construction projects. Larry loves to cook gourmet food, and he and Barbara are educated in the Renaissance style. For a thrill, maybe he'll let me shoot the incredible sniper-type rifle he bought for who knows what reason; everyone in those parts seems to be armed to the teeth! The last time I visited, we ate sausage that Larry made himself, starting from a live pig. This will definitely be our second stop in the country!

Then, on to Hendersonville, North Carolina, to visit my mom and check out a condo we've owned for a few years - it's our bailout place if Rochester winters ever get too much to bear. Hendersonville, set in the foothills of the Blue Ridge, is loaded with retired northerners. I'll play golf with my 83 year old step-dad, who braves painful foot neuropathy to stay connected with his favorite sport. My 88 year old mom is still going strong, healthy as anything and working hard painting watercolor portraits and people scenes. Some people just have the great genes!

Then, back to Rochester via scenic West Virginia. The trip will put well over 2,000 miles on my van, but none of the driving days will be obscene because the Good Witch mandates regular pit stops.

The two of us have been to lots of places in this country and Europe, we've stayed in some fine hotels in the big cities, and we've lounged in the sun on beautiful lake shores. Now, those kinds of vacations are over, just because they're our history and don't need to be repeated. But "family" seems to become more and more interesting as the years pass and everyone mellows. We'll relax and talk over a soft drink (Kentucky), a bourbon whiskey (Tennessee), or a Scotch (North Carolina), and get in a few rounds of golf if the weather allows. That's what "vacation" has become, and that's just fine with me. Maybe I'll post a few pictures on my return.