Proclaiming Softly

2009-12-21T21:32:00.004-06:00

Lovely poem for this season: The Birds by Frank Vollmer

Just be glad you have a job.

2009-11-05T12:36:00.005-06:00

Since this recession began, I've heard a number of people comment about someone else's employment situation: "He should just be glad he has a job." Well, yes, there is some wisdom in that statement, especially considering that a small city nearby, the unemployment rate is 17%, although it has gone down below 8% in the rest of this state.

I've heard about my friend's daughter who has a high profile job that her college degree prepared her for: she earns only a little above minimum wage. She has to look at this job as a stepping stone to a bigger and better position elsewhere.

I've observed what has happened to my son in his young work life. He worked at an entry level position for a company where he had interned. The pay was decent and there were benefits, but they broke promises to him about helping him financially to get classes so that he could take on more responsibility.

Then he got a "management" position at a large Big Box Store (no, not Wal-mart.) The pay was poor, considering that he had to have a specific college degree to get that job, and if you wanted benefits, you had to pay for them, which is hard to do when your pay is way less than it costs to attend college for a year. BTW, the owner of this business is a billionaire. But at least my son had some income, even it hardly covered his expenses.

Next he got some pick up work involving scraping and painting apartments. The pay had no tax subtracted from the gross amounts and the apartment owner had no building permits. There were no provisions for safety of the workers. And, oh yes, these apartments are in one of the most upscale areas of the city where many buildings are owned by this one man. But at least my son had a job. For two months.

My son moved to another part of the US where many people work for minimum wage, although that is higher than it is here. He got a job in a Big Italian Restaurant Chain, which pays whatever the lowest legal wage is, depending on which state they are in. Where he is, they pay $2.13/hour because there are tips. Yes, that is correct, I verified this on that state's website. The people tip 10% if the waiter is lucky. That wage is down more than $1/hour compared to two years ago. In this state, minimum wage in $6.25/ hour or $5.25/ hour, depending on the size of the company. How is it that the same restaurant chain can pay $4/hour less for the same work, just because the building is in another state? Oh, that's right, don't question, just be glad he has a job.

Well, Son was also applying elsewhere, and one place called him back for three additional interviews, but would not tell him what the salary would be. Then he was offered the job. It was a job with a good company and included benefits, but the salary offered was surprisingly low, considering that this is a lower management position. After thinking it over, my son decided he could probably do better as a waiter, so he said no because of salary reasons. Well, surprise! The manager called him back and offered him the position at a salary of 25% higher. Now I am glad that my son has a job.

During this recession I've come to the conclusion that the owners of companies, who may be making less than before, but who aren't starving, use the economic climate to get people to think, "At least I have a job." Wages are kept low and the wealthy owners can keep their accustomed life style.

2009-10-30T15:36:00.005-05:00

Helen again is her sharp witted opinionated self. On 24 hour news: " News as it is happening is not news. It’s an observation without much thought. " And that's one of the mild opinions. See the blog in which Helen records her wry comments about the political scene. Click on Margaret and Helen: Margaret and Helen

Single payer health insurance mandated by the government...???

2009-10-25T16:04:00.000-05:00

Article 31 of the Iraqi Constitution, drafted by the Bush administration in 2005 and ratified by the Iraqi people, includes state-guaranteed (single payer) healthcare for life for every Iraqi citizen.

read about it here.

$1800 View

2009-10-18T12:04:00.004-05:00

Yes, there is a story behind why I had this view, but I'm not sharing.

Priorities, keep the straight!

2009-09-29T16:38:00.001-05:00

Many years ago, my grandmother cut this poem out of a newspaper, made a notation,"how true," in the side column, sent it to her cousin, and eventually got it back. Somehow it came into my possession. I've treasured it. My grandmother DID have her priorities straight in life when I knew her. She was a lot of fun and admired by many friends.

Of Things That Are

Lovely and Fleeting

The dust on the piano keeps better

than the flashing

Of loveliness, keeps better than

the clean slant of wings

Across the cool garden, where the

honeysuckle berries

Call the brown song sparrow that

balances and sings.

The undone ironing keeps better

than the beauty

Of the star-hung plum tree in

the drying yard,

And the undarned socks will out-

last the radiance

Of a sunset's glory to its last

bright shard.

The tarnish on the spoons keeps

better than the mischief

In a wee girl's eyes or the sun-

light on her hair,

And the stacked supper dishes will

long outlast the clinging

Of a small boy's arms and his little

whispered prayer.

Ah, life is so short and the earth

is so beautiful,

And boys and girls are children for

such a little while--

So we run n the orchard and look

for the four-leafed clovers,

And we know a spotless house isn't

worth a baby's smile.

By Leona Ames Hill

Work toward improving outcomes and don't spread lies.

2009-09-16T14:43:00.003-05:00

This article is a physician's view of the arguing and division and contention about the health care issues among the politicians. Quote from the article:

In health care, we improve outcomes by working as an integrated team as well as through respectful and constructive competition. This never involves spreading lies about our colleagues' opinions or motivations. We are able to respectfully disagree, compromise and work toward the best interests of our patients, regardless of personal and philosophical differences.

Against Government Involvement in Health Care? Oh, are you really against Medicare?

2009-09-15T09:35:00.005-05:00

While watching some of the news coverage yesterday, I saw the reporters putting the microphone in from of some of the protesters in Washington. Several of these people were clearly senior citizens, and several of them said that the government shouldn't be involved with our health care.

My reaction: YOU HYPOCRITES!

I think these people are taking for granted their Medicare benefits. They are potentially entitled to more financial compensation (Medicare as insurance payments) for their medical care then they have paid and are paying into the Medicare pot. The rest of the wage earners are paying with the Medicare deduction from their paychecks.

Senior citizens are more likely to need prescription medications than younger people. Now, thankfully, there is Medicare D, which helps pay for this benefit. One of my relatives was complaining about the "doughnut hole" in Medicare D. Yes, there is a significant out of pocket expense after a certain dollar amount is reached. But isn't she forgetting that in the previous years, after her husband lost his medical insurance, she was paying for ALL of these medications out of pocket? At one time she told me that she and her husband were paying about $500/month for prescriptions.

Patients who have certain conditions need to have lab tests periodically to make sure certain blood levels are in a healthy range. Medicare patients don't have to worry as much about the costs.

End of life illnesses often mean very high medical costs for the last year of life. Much of this is covered by Medicare, and if the patient also has a Medicare Supplement insurance policy, his family isn't stuck with a big debt after the patient passes away.

I think we take for granted a number of quality of life issues these days because of Medicare. Think of all the people you know who have had knee or hip replacements. The surgeries and hospital after care are expensive. The patients go to physical therapy to speed the recovery and increase the chances that the patients will have good mobility in the following years. They may get more enjoyment of life during their golden years if they can walk comfortably and play with their grandchildren. Joint replacement patients who are seniors can spend a few days in a rehabilitative nursing home immediately following release from the hospital if they wish, which often speeds the recovery and therapy. Who could afford these surgeries and therapies pre Medicare, when many people would have no insurance at all after retirement? One man I know, who is clearly "not poor" had an accident which severely injured his hip. He got by with reduced mobility so that he could wait until he qualified for Medicare before he had his hip replacement surgery.

Medicare patients who live in a nursing home are seen by a doctor every month, or in some practices, by a physician every other month, and a CNP on the off month. Those nursing home patients who are not on Medicare don't fall under a doctor visit requirement. Elderly nursing home patients get therapy evaluations when they enter the nursing home, paid for, of course, by Medicare.

Are there problems with Medicare? Of course. And we know that through the years the percentage of the costs paid for by Medicare has shrunk, which is a concern. But the purpose of this post is to highlight areas of care that we might be taking for granted after so many years of Medicare.

I am basing the above information on my own knowledge. I was a certified insurance counselor, helping senior citizens with coordinating their insurance coverage for several years. I have the personal knowledge of dealing with my mother's finances, especially with her medical bills. Actually, there have been no problems with the Medicare and supplemental insurance payments. I've seen my mother-in-law have a hip fracture, replacement, and nursing home care, and be able to have a very high quality of life afterwards. Actually, due to falls, she has been in the nursing home three times, gotten therapy, and moved back home each time. I doubt she would have recovered as well if there hadn't been the therapy paid for by Medicare.

And I've had extensive discussion with a Family Physican who is also board certified in Geriatrics and who has extensive experience with nursing home patients. His assesment of Medicare is that it requires care for a lot of people who would be neglected or overlooked without it.

My Health Insurance Company's Profits

2009-09-11T11:01:00.003-05:00

And, no, I don't have options to choose from. And, yes, I have gotten good service from this company.

The Medical Quack: UnitedHealthCare Profits Doubled Compared to Same Quarter Last Year

The Medical Quack: WellPoint (Blue Cross) and Aetna Profits Sink – UnitedHealthCare Profits Doubled

3rd UPDATE: UnitedHealth 2Q Profit Doubles, Membership Declines - WSJ.com

UnitedHealth Group Q2 Profit Jumps 155% (UNH)-07/21/2009

UnitedHealth Posts 15% Profit Increase and Raises Its Full-Year Forecast - New York Times

United Healthcare Denies Coverage to Kids, Reaps Profit | NowPublic News Coverage

UnitedHealth profit soars 155% | StarTribune.com

How The Profit-Hungry "Medical-Industrial Complex" Hurts Health Care (VIDEO)

Interesting take on excluding illegal aliens from health care benefits.

2009-09-10T10:41:00.004-05:00

According to this article, the 2005 law excluding illegal aliens from Medicare has had "interesting" consequences, including high costs as well as the *possible* exclusion of lots of the rest of us. This may be a bit of hyperbole, but it is good to remember that there are costs related to the administration of exclusion as well as to inclusion.

Health insurance company profits

2009-09-10T09:32:00.004-05:00

Some people are old enough to get away with being blunt!

Just a taste of this:
Folks, let me tell you something about healthcare and health insurance. There are a couple of ways to make a buck in the game. One way is to systematically deny coverage to anyone with a propensity to get sick as evidenced by past occurrences. The other way is to spread the risk over the largest population possible effectively minimizing the impact of the most risky. But there is one way for sure to lose a buck – keep increasing the number of people who can’t pay their bill. It’s really quite simple. A public option means insurance companies will report profits using language like “impressive” and “satisfactory” rather than “awesome” and ”a buttload of moolah!”

Supposedly the CEO of the health insurance company that I use has a several million dollar/year salary, plus $95 million in stock options. But I don't even know what stock options are, so what does that mean to me? But it must be legal, because the attorney general of my state won a lawsuit against this company and already got them to clean up their act. How many people who get their applications rejected for pre-existing conditions would that cover?

And talk about pre-existing conditions.... a good friend's child had strep throat, about a year after switching insurance companies, due to a change of employment. Well, guess what? The child had had strep throat in the past, so they declared it a pre-existing condition and rejected the claim. Strep throat, dear claims examiner, is not a chronic condition normally, so it really can't be a pre-existing condition in the general meaning of that terminology.

My friend's employer (major health care delivery organization, meaning clinics and hospitals) deleted her department. She was hired by an independent small company. She doesn't earn health insurance there, so she is paying for COBRA coverage, meaning, paying independently for her previous insurance. She can't afford to let it go, given that she really does have a pre-existing condition, namely, two cancers that were cured. The premiums she pays now are HALF of her entire SALARY. She is a health care professional, so her pay isn't peanuts. What to do? Her husband may take on a part time job just to pay for the insurance.

Newscasters and Reporters

2009-09-09T09:48:00.001-05:00

There are so many news shows on TV, 24/7, plus the network news show, plus the local news shows that, I believe, there are a lot of reporters who aren’t quite up to what I would consider a minimum professional level.

On one of the morning shows, the renowned anchor constantly asked a “fact filled” question, putting words into the mouth of the subject, leading him in a preconceived direction rather than letting him speak.

On another network, the anchor, who I really like personally, asks questions that solicit emotional answers, but the anchor shows his own bias by making sympathetic remarks to the subject at the end of the interview. These remarks are not out of line on a human level, but don’t fit any kind of mold where the reporter is trying to be unbiased.

On the 24/7 news networks, the so-called news shows have “personalities” who go back and forth across the line between giving the news and commentating on the news. I don’t mind those who clearly state their biases and editorialize overtly; that’s fair to the viewers. But on some of the shows, the news people don’t draw the line. I don’t think they see the line. I always wonder if these people, who come out so clearly on one side or the other, are speaking for themselves, or if they are speaking for the moneyed people who own the network. I wonder how much independent research they do before giving their pronouncements.

The Right, The Left, is there any Center?

2009-09-07T09:42:00.002-05:00

Whose "right" anyway? Can you be right if you are Left? Can you be civil if you are Right or Left? Here's a good essay on the discourse of the day.

Quotes that seem to sum up the news of the day. Darn it all.

2009-09-03T15:26:00.002-05:00

Think twice before you speak, and then you may be able to say something more insulting than if you spoke right out at once.
- Evan Esar

There is no such thing as an underestimate of average intelligence.
- Henry Adams

The most merciful thing in the world, I think, is the inability of the human mind to correlate all its contents.
- H. P. Lovecraft

These quote were the quotes of the day on my Google page.

Electronic Medical Records, next

2009-09-03T11:29:00.003-05:00

When I was at the consultant clinic recently, as mentioned in the previous post, I received a computer printout, handed to me as I left, of what had transpired during the visit. On that paper was written that I was to receive a new prescription, as discussed during the visit. It was never discussed. It was for a supplement that I've used for years, because my body doesn't processes this chemical efficiently. Too much or too little can cause a person to have major health problems. My intention has been to point out this error during my next visit, which won't be for another month and a half from the first visit.

Meanwhile, I went to my local pharmacy yesterday to pick up my normal prescriptions, which should include the supplement mentioned above. All well and good, until I realized that I was being given TWO additional bottles of this prescriptions. Fortunately, I knew better than to buy this and use it.

I know what happened. The admitting nurse at the consultant clinic had entered my prescriptions into the computer and inadvertently entered that this was a new prescription. The computer automatically, with no human oversight, sent the prescription to my pharmacy. To my dismay, there also seems to have been no human oversight in getting the "schedulers" at that clinic to call me to schedule future appointments and tests. Let's just say: Grrrrrr.

Electronic Medical Records

2009-09-02T10:46:00.001-05:00

The topic of electronic medical records has been big in the news. Our governor is pushing for it in all state health care facilities. It might even be required. Supposedly, nationally, "EMR" will save a lot of money and make medical care more coordinated, thereby making it "better." All these things remain to be seen.

I like computers and I do think that, ideally, EMR would be an improvement, but like all things in life, it can be a mixed blessing. I've had several personal encounters with EMR that show the downside and pitfalls, but the previous system, all in all, was probably worse.

A couple of years ago, my son went to a clinic, had a cursory check up and test, and got a prescription. We got the bill, insurance EOB, etc, and paid our portion of the bill. Our son had to go for a few monthly rechecks, so there were more bills, but the next statements were for much higher amounts. We questioned the higher fees by asking him what exactly was done at each visit, and we also wrote to the clinic. The clinic manager replied that the fees were justified by what the doctor had done at the visits, based on the charts. Our son OK'd release of the records, which showed a complete history and physical at each visit, which my son said was not done. We had the records reviewed by a physician, who agreed that the doctor could not possibly have done what he said was done within the time frame that was electronically recorded on the records, plus the time frame on the records agreed with my son's recollections. And the supposed H&Ps were not justified. When confronted, the clinic and doctor agreed that the doctor had used the EMR incorrectly, that is, he just checked off that he had reviewed every bodily system completely. They refunded the charges and corrected the records, and stated that they were going to review all the charts from that doctor.

I have been a patient at the same clinic for many years. My paper record files are quite large, so that looking up any thing old is inefficient. Ideally, a physician will keep a record on the front cover or front page of the current medications and problems. Not all physicians are that organized. My clinic converted to EMR a year ago. My yearly visit was on the first day of the new system, so they hoped I would be patient, which I was, but it was easy to see the pitfalls. First, somebody had put some of the old records into the system. Imagine how expensive it must be to input lots of old files. I had to fill out a paper form with a list of my medications, over the counter meds, as well as past surgeries, etc. It was like just like the paperwork one fills out when going to a new clinic. This was then entered into the computer by a clerk. Obviously there is a great chance for error or omission in my memory. There is even a chance for deliberate omission. The good side of my clinic's system is that the computer sent me a letter after the visit listing the results of my blood tests as well as the meanings of the values. I also got a note from my doctor, so I knew that a real person had reviewed the tests.

Recently, I went to a certified nurse practitioner at another clinic. Before I saw her, I had to fill out papers, just like I mentioned above. Then nurse entered all the lists of medications, previous surgeries, etc. into the computer. Then the CNP did a very thorough history and checkup. She entered a number of things into her computer, which printed out a paper for me. It told what we talked about, what was recommended that I try, what tests were ordered, plus my list of medications, and notations about past immunizations, etc. I was impressed with this printout. For one thing, I can't remember the medical jargon or the names of tests I don't understand, but now I have them listed in writing. Secondly, it let me see that there might have been a couple of misunderstandings in my communication with the CNP. But since this isn't my primary clinic, there were gaps in my record. It looks like, for example, that I've way out of date on immunizations and certain types of normal yearly checkups.

The CNP is talking about a specific test that I may have, but it involves some medications. I believe I've had these medications in the past, but, of course, I don't know specific names, amounts, etc, but I know I've had some very uncomfortable reactions. I decided to write a request for past records so that I can be sure about what meds I'd rather not have. I received a packet in the mail for a company whose business is going through old medical records.(??) This contained photo copies of exactly what I asked for, so I expected it to be helpful. Well, the suspect medications were clearly listed. But there were no amounts given listed. On all the pages but one, the notations were in various handwritings, some quite messy, or barely legible. I really don't think this will be helpful.

The next point has to be handwriting vs. typing. Typed notes are clearly better for future use by other people. In the past, some doctors just wrote, or scribbled, notes into their charts. Some doctors dictated their notes, which were then transcribed by somebody else, and, if the doctor was compulsive, the notes were read and countersigned by him/her. Medical transcription is a dying art, not taught in schools as in the past. These days, the doctor has to type his own notes. The plus side is that they should be readable and they should be correct since he/she can see them as he/she types. [Yes, some doctors do use a program such as Dragon Speak to avoid the typing.] The down side is that we are paying doctor's salaries to the typist. EMRs do contain a number of features that can streamline the charting process if the doctor knows how to use them. Some EMR programs necessitate that the doctor must finish the record before signing off, which would mean that the doctor could be late for the next patient or, OTOH, that a particular doctor still uses old note taking methods and goes to the computer later in the day or week to finish the records, which, of course, undermines the value of the EMR system.

Lastly, to be at their best, either all clinics and hospitals have to use the same EMR system or the systems have to be compatible. When I was going to see the consultant/specialist, my basic records should go with me, but they didn't. I had to tell them about my history and my doctor had to include a few photocopied pages of tests with his introduction letter. Obviously, this is still very inefficient.

In the long run, if EMR is used by all clinics, hospitals, and doctors to the fullest extent, records should be more complete, efficient, and useable. Doctors should be able to look at charts showing trends of testing, for example, rather than just looking at a number of screens showing various values of test results. At this point, much of EMR is just using the computer instead of paper, the computer being a glorified typewriter. There are doctors still resisting using the computer for their recordkeeping. There are the usual computer hassles we all have run into that does make us suspicious of keeping important documentation in the never-land of digital information. EMR is far from an ideal system, but the thick stack of papers, possibly disorganized, in a tradtional medical chart, with many notes handwritten, seems to have even more drawbacks.

Need a job?

2009-09-01T18:15:00.003-05:00

Three in my family are currently looking for work. I should send them to this place.

Remembering a civil America

2009-08-29T07:56:00.002-05:00

Here's a blog that tells it like it is. The writer is too old to worry about being anything other than "frank."

Well of Course, Ted Kennedy

2009-08-27T16:07:00.004-05:00

Whenever a famous person dies, the TV networks go all out with tributes and commentaries and old movies and video of the person. So often I learn more than I knew before or I learn about some of the quiet traits of a person. Sometimes the descriptions don't match my memories, so I wonder.

When the list of the causes that Ted Kennedy supported, worked for, fought for, and even took risks for came on the TV screen today, I said to myself, "Well, of course." By that I meant, well of course a person would be against the war; well of course, a person would want to help people with disabilities; of course, a person would work against apartheid. The list was quite long.

So many of these things that Kennedy promoted, and worked for, are things that people now take for granted. Hindsight is wonderful; it lets us forget that some things were just not there for certain groups at one time. We forget that some people, not just senators, went out on a limb for certain causes, even suffering for a cause. We get to take good things for granted. There may also be things that I disagree with or ideas that are good, but the implementation is problematic. But all in all, Kennedy worked to make life better for many people.

About the time that Reagan was president, Ted Kennedy was promoting a single payer health care system. I was adamantly against this. I had selfish reasons. With the benefit of age, I can see now how strained out current health care PAYMENT system is, and how close so many of us are to losing our insurance, if we even have any. And I see how some people have to pay a lot for insurance because they are not in a group or in a small group, while others practically have it for nothing. Some employers are generous; my son worked for a billionaire's large company where the $8.00/hour employees could buy their insurance if they chose to (yeah right.)

I sincerely hope that we can honor the memory of Ted Kennedy by getting a new system that treats people fairly and does away with the ridiculously complicated insurance claim system that clinics now have to deal with. Good health care needs to be available to everyone. A simplified health care PAYMENT system should be a reasonable goal.

Pay more taxes?

2009-08-24T13:09:00.002-05:00

Some people are volunteering to pay more taxes. What do you think? I sure think that people who complain about taxes and yet choose to use all the services we are privileged to have are not connecting the dots. And I don't think we should foist the costs of our privileges and benefits off onto our grandchildren.

Heads will roll...

2009-08-22T09:38:00.005-05:00

Follow-up to my previous post: I found a link on the clinic's website for asking a question. I asked, "How do I get a scheduler to call me and how do I get a call back from the department?" I signed my whole name. I received a quick reply, stating that the person would try to help me if I gave the department and my phone number. I wrote back with the whole story of having 4 people say that a scheduler would call, but after a week, no call, etc. But I also asked the question, "Do you think that this is what the providers expect when they want test done?" If there is a good reason for a delay, it should be communicated. I explicitly asked for no special treatment, but that there should be better follow-up in general.

I got a follow-up email saying that my email was forwarded to a department head. This was at 8:00 am. At 11:15 am, exactly one week from my initial appointment, I finally did get a call from a scheduler. I scheduled my appointment, then I asked her why she had called. She said her supervisor told her to call. I told her the whole story, so that she could understand the patient's point of view. I thought she was genuinely empathetic and understanding. She said she will personally follow up on some details.

But when I wrote that email, I thought to myself, I will just document everything and if they don't exhibit better customer relations, I'll send the info to the CEO. Head will roll.

BTW, I am always extremely complimentary when I write if there are positive aspects of a situation. I find I get better results that way.

It was like a plague of locusts

2009-08-21T10:29:00.005-05:00

Yesterday a pastor-blogger posted a piece which said that the tornado that just missed the Convention Center but hit the church steeple across the street, as well as numerous homes quite a bit south of there, was evidence of God's judgment regarding the various votes that the ELCA is taking this week. No need to go into detail; those of you who are in the in-crowd on this know what I mean.

I made a comment, not about the issues voted upon, but about the idea that how could anybody possibly know God's mind. And isn't it just possible that we could interpret it as the convention center being spared? And what happens when that pastor's parishioners have storm damage, how does he counsel them? Pastors who claim to understand the mind and intent of God are an irritation to me.

Commenters were all over the place in their views, praising the pastor, condemning the sinners, warning all of us in the US to be wary of God's wrath because of materialism and gluttony, praising God for loving all of mankind, etc. Some posters keyed in on literal interpretations of the Bible, in a particular English version, of course. Others cited verses about God and/or Jesus controlling the weather. Others gave verses about certain things happening to people regardless of whether they are righteous or not. One person even looked into the history of the blogger's church and claimed that it has been hit by a tornado in the past. You get the picture.

I got about 400 comment emails in my in-box. They wouldn't turn off. I repeatedly clicked the unsubscribe. Finally, there was a long comment from another pastor who called the original blogger on the carpet, detailing errors in specific references to scripture, citing science, citing errors in interpretation and inconsistencies, of both scripture references and from the blogger's past writings.

Then the comments stopped. Cold. I checked the blog and it no longer showed a comment box. But this morning, the plague of locusts returned.

How long are they going to keep me waiting?

2009-08-20T13:53:00.003-05:00

Last week I finally had a medical appointment with a nurse practitioner at an extremely large clinic in a far city for an on-going health problem. I've lived with the problem for a long time; I know it isn't going to kill me, but there are reasons to make sure there aren't other problems that are masked by the main symptoms.

This appointment was set up through my regular family doctor, and it took about 5 weeks until I could get in. I had hoped to see the specialist, but I was assigned to the CNP. I thought she was really good. She asked about 100 questions and made a point of making sure she understood my answers. I was impressed. I've actually seen another specialist twice a few years ago, at another clinic, but he asked only a few questions, proclaimed a very general diagnosis, never even checked my body, and sent me on my way with no tests, with no care plan or suggestions or patient information about the supposed diagnosis. Needless to say, I was POed.

The CNP told me what tests were needed; that was not a surprise, because I've had those before elsewhere. She told me to stop taking one medication, but to start two others. She then walked me out to the desk, where she told the clerk to schedule me for four tests and a followup visit. That woman said, "I don't know how. The schedulers are in the back." She asked me if my phone would take a message when they called.

I had no message when I got home. I had no calls the next two working days. But by then, it was obvious I was reacting poorly to one of the medications, so I called the office and said that I was in "extreme pain," that I wanted to stop the medication, that I wanted to talk to the CNP, and that the schedulers hadn't called back. The response was that she would "send an email" to the CNP's nurse and that the schedulers were very busy. Six hours later, I was called by the nurse. Same story. She'll send an email to the CNP. She'll tell the schedulers. The scheduler called at 5:03 pm, made one of the test appointments, but couldn't make the rest because everybody had gone home.

Two days later, I'm feeling much better, but I still haven't heard from anybody else.

I've already written two complaint letters, but I haven't mailed them. I was too hot about this when I wrote the letters, so I know better than to send something like that. Since I'm feeling better, I've decided to wait about another week, and then I'll write to the CEO, not just to the department. Unfortunately, I've learned today that this may not be an isolated incident. I asked a friend if she had ever been to that clinic. She said no, but related a very similar story about a good friend of her's, but in that case, the person had a disease that was fatal if not treated promptly.

In my most desperate and snarky moments while waiting for the call backs, I've contemplated what I might say to the schedulers if and when they do call. I might say, "Oh, you want my sister. She was in extreme pain when she called on Tuesday. She keeled over and hit her head, and is now in surgery." Or maybe it will just be, "Can I have your name and the name of your supervisor and the head of your department, as well as the CEO of the clinic?" I honestly hope that I'm not feeling humbled and grateful that they finally decided to call.

How did kids ever get by before moms had internet?

2009-08-13T11:47:00.003-05:00

My son and daughter-in-law moved, within the week, to a hot and humid state. The move went well, but there were some issues with their new apartment, so they couldn't move in immediately. And they couldn't move in even after 3 more days, even though the apartment management knew when they were to arrive. And they had a considerable amount of money invested in the deposit and first month's rent. Of course, they went looking for alternative apartments, even though there might be some financial ramifications for leaving the first place.

Meanwhile, expenses are adding up, plus they needed funds for the new apartment. Apparently, their banks back home must have decided that their credit cards were stolen, because the ATM machines wouldn't honor their cards and passwords.

My son has been on the phone with me numerous times this week, so I've been on the 'net trying to get some information to help them out: location of their bank in new city (oops, not in that state at all), laws about renting and getting one's deposit back (probably can't get the money, even though the apartment isn't ready), phone numbers of lawyers, just to name a few things. It is pretty hard to try to take care of business and find a place to connect to the 'net when one is new in town.

My husband and I couldn't help but reflect on how complicated life has become for young people. We were never asked for any detailed financial information when we were renting. We were never asked to have a guarantor for our rent. We didn't have plastic money, so there was never a possibility of getting cash quickly, nor was there a chance of easily going into debt. We did get married when we were both unemployed and the unemployment rate was high, but when we got jobs, we got good health insurance.

This situation also triggered a memory of my older daughter's move to a state out east. The day after she moved into her apartment with her husband and new baby, she took her husband to work for his first day at his job. She got her keys locked in her car when she got back to the apartment. She had no acquaintances there, was not within walking distance of any stores, didn't know her husband's work phone number, and had no phone book or internet connection. She called us so we could look up all the information on the 'net. Unfortunately, the phone number we got for her husband's work was wrong, so the best we could do was find a locksmith and also the phone number for the local police department.

I guess being resourceful these days is different than being creative used to be. Back in the day, as the kids say, I would have had to knock on doors to get help. What else was there to do? That does have advantages, even if it has more risks.

Rationing Health Care

2009-08-11T08:41:00.002-05:00

Another way of framing the current LOUD debate: whole article here.

In Palin’s fantasy, the death-panel “bureaucrats” were going to pick winners and losers based on a judgment about their “level of productivity in society.” Well, if you view income as a gauge of a person’s productivity in society—and God knows there are Republicans who do—then the quality of health care is already correlated with “productivity in society.” Obama’s plan, by making health care more affordable to lower income people, would make that less true.

This is just another way of making a point already made by Peter Singer in response to less delusional concerns about the possibility of rationing under Obama’s plan: we already ration health care; we just let the market do the rationing.