Healthcare

Healthcare in America stinks. We pay more than other civilized countries, and get worse results. We wouldn't accept this when buying a car, would we? Imagine comparing your car to your neighbors -- I paid twice what you did, and have twice as many repairs! What kind of value is that?

The problems are many. Too many people don't have any health insurance. Those of us who do have insurance pay too much for it, or are forced to buy plans that don't have enough coverage. (So-called high deductible plans.) If we go to change plans (when we move, or when we change jobs), many of us are denied coverage because of "pre-existing conditions." All too often the health insurance companies deny treatments and medicines recommended by our personal doctors. It all costs too much, as well -- we spend more per capita on healthcare than any other Western nation. And, despite the costs, the results are abysmal, no matter how they're measured.

Let's look at these points one by one.

Why, some might ask, must everyone have health insurance? What right does the government have dictating whether or not we have health insurance? If a person decides to not have insurance, why should I care? This one's really simple, as explained to me by my old doctor back in Indiana. He was for national health insurance, for this reason: "I don't want the guy next to me on the bus to have pneumonia." It's a selfish reason, but a good one. When everyone has good health care -- good preventative healthcare -- there will be fewer sick people around. And the fewer sick people around, the less likely it is I'll get sick from them. Ta-da! Beyond that, there's the simple humanitarian aspect; if somebody is sick or hurt, we should help them; who's paying for that service shouldn't enter into it. Think of it this way: If your child is sick or hurt, you want him to be cared for. It's not a matter of health plans and deductible and payments, you want your kid to get better. It's no more complex than that.

Then there's the paying for it. In years past, it didn't cost that much -- especially if you got healthcare through your employer. But costs keep going up and up and up, so that not having insurance might be the only option for those with low incomes. It's even a problem for employers, who are facing increasingly substantial costs for this employee perk. In fact, it may be the employers who finally push healthcare reform this go round; even the biggest corporations are getting on the bandwagon due to increasing costs. (In addition, our system is blatantly unfair; the poorest fifth of Americans spend 18% of their income on healthcare, while the richest fifth pay only about 3% of their incomes. That's not right.)

That said, those who have insurance as part of their jobs are the lucky ones. Go out on your own -- change jobs or move or whatever -- and you're likely to be turned down for coverage. It's the old "pre-existing condition" deal; if you're taking any type of medicine, even if that medicine helps to reduce your long-term medical costs, insurance companies don't want to pay for it. It gets worse the older you get; hell, at 50 years old, I am a pre-existing condition! So just qualifying for care (at reasonable rates) is a big issue these days.

Just having insurance doesn't guarantee you can get the care you need, however. How many of us have had their insurance companies deny some sort of treatment recommended by our personal physicians? Most, I'd wager. Every time my old doctor tweaked my medications, it would automatically be denied by my insurance company. EVERY SINGLE TIME. I've heard it said by people who work for insurance companies that they're instructed to automatically deny every claim the first time; even if they end up approving a second request, a certain percentage of people immediately give up, thus saving the insurance company from paying. That's cold, folks. I really don't need some minimum wage flunky in an insurance company cubicle overruling the advice from my personal physician.

So this overly bureaucratic system works hard to deny healthcare to millions, but despite that, it costs the country as a whole much more than it should. I suppose I could live with lousy service if it came cheap, but here in America we pay Rolls Royce rates for Kia quality. That's the gold ol' U.S of A., paying more than any other civilized nation. In 2000, the United States spent 13% of its gross domestic product on health expenditures. That's 22% more than the next most expensive nation, Germany (10.6%). Why are our costs so high? It's a combination of things. First, because so many people are uninsured or underinsured, they don't get proper preventative care, and they wait longer to see a doctor -- and this later, more emergency care costs more. Second, our system is a for-profit system, most health-related companies are public companies trying to meet quarterly profit goals for their investors. Third, these companies are heavy on the expensive management, and we all know how that works. Fourth, there is really no organized pressure to keep costs down, as there is in other countries; witness the lower costs for prescription medicines across the border in Canada. Fifth, there's the simple cost of bureaucracy; the administrative costs of private insurance run 16% of the total budget, while Medicare (that's a government-run program, for those keeping score) costs run only about 3%. (Ask your doctor how many people he has employed who do nothing but deal with insurance companies; you'll be shocked.)

The worst thing is, even paying so much for our healthcare, we get worse results than countries who pay much less. The statistics are overwhelming on this point. The WHO ranks the U.S. 32nd for infant survival and 24th for life expectancy; the Commonwealth Fund ranks us 15 out of 19 with respect to preventable deaths before the age of 75, and last in terms of both infant mortality and life expectancy. We pay more and get less in return. Would you accept this for anything else you buy in life?

So what is the solution? Well, it calls for a complete overhaul of our healthcare system -- not minor tweaks, as some might suggest. That means rethinking everything. We have to reinvent what we have; simply switching from paper records to electronic ones isn't the solution.

Our options, fortunately, are many. We're not the first country in the world to embrace national healthcare; in fact, we're just about the last. So we have the luxury of observing what other countries have done -- we can see what works and what doesn't. Take one from column A and two from column B, and build the best healthcare system in the world.

There are several approaches used in various countries around the world. One approach has the government run everything; the insurance companies go away, and all doctors and hospitals are government run. Another approach keeps doctors and hospitals private, but has all costs paid for by the government; again, no insurance companies are involved. A third approach keeps the insurance companies, but they're forced to provide low-cost coverage for all citizens; in return, they can upsell fancier (and more profitable) coverage to those who want it.

Each of these approaches has its pros and cons; none is 100% perfect. But all of these approaches cost less and get better results than we have today. Changing to any of these plans would be an improvement -- for all of us.

Big change has to happen, and happen fast. Unfortunately, we can do this only if our politicians have the willpower to do so -- which they don't seem to have. Right now, even the most populist politicians are sounding like rank and file conservatives, primarily because they're well funded by the healthcare lobby. The healthcare industry pours hundreds of millions of dollars into the coffers of politicians of both Democratic and Republican persuasions, with the result that few elected representatives are willing to embrace the total change that we need. "We must preserve the status quo," they cry, even if that status quo benefits only their big money donors. Us regular folks, who overwhelmingly embrace public healthcare, are left in the lurch.

This is the time for a populist uprising. All of us need to write our congresspeople and senators and president and make known how much we need and want dramatic change. Yes, we're talking public healthcare, and that will mean some disruption (mainly in the insurance industry, those fucking leeches), but it's what we want and need and must have. The insurance agency (and their well-paid lobbyists) be damned, we must force our elected official to do what is right and what is needed. This is no time for compromise (hear that, Mr. Obama?); this is time for action. Otherwise, the United States will continue to be the laughingstock of the world community, paying more and more to become less and less healthy. It's not right.

But that's just my opinion; reasonable minds may disagree.

Jackson

Michael Jackson is dead, and the media is going apeshit 24/7 with Jacko coverage. Frankly, I've had enough. It's just not that important.

IMHO, Michael Jackson was never the "king of pop." His best records were his first ones, with the Jackson 5; they had a youthful exuberance and represented the next generation of the classic Motown Sound. (Due more to Barry Gordy and his producers and writers than to the performances, I'd wager.) Jackson's most famous records, as a solo artist, certainly sold well, but they weren't groundbreaking. They may have represented the logical culmination of then-current producing and recording techniques, but they didn't push the envelope in any way, shape, or form. You want groundbreaking, you listen to Stevie Wonder or Marvin Gaye. Jackson's stuff was entertaining, but that's it. Not an innovator at all.

Jackson's music was popular, however, for various reasons. Well, it had a good beat and you could dance to it, of course. It also helped to break genre and color lines, especially in the world of MTV and music videos; in this way, Jackson was more of a cultural phenomenon than a musical one. But the songs, the records, they just don't have any staying power. Does his stuff get played on any radio stations today? (Well, other than the 24/7 mournathon we're currently in, that is.) No, it doesn't. The earlier Jackson 5 stuff does, because it endures. "Thriller," "Billie Jean," all those songs, they're easily replaceable. They don't stand out, they're too representative of their time; they simply don't wear well over the years. That's not great music, folks.

Yeah, yeah, yeah. I know, Jackson was a captivating entertainer and dancer. So compare him (probably unfavorably) to Fred Astaire and Gene Kelly, not to Elvis Presley and John Lennon and other true musical innovators. You want musical innovators, talk about Chuck Berry and Little Richard and the Beatles; don't talk the so-called "king of pop." If anything, he was the king of cloying pap. Nothing more than that.

But I don't think he was a king at all, and I'm tired of hearing Michael Jackson talked about as if he really, truly, changed the world of music as we know it. Even his so-called accomplishments were really collaborations with (and driven by) Quincy Jones. What were Jackson's contributions? A few squeaks here and there and the introduction of the moonwalk -- which was itself an appropriation of existing dance steps. I'll give him one thing; he helped to turn pop concerts into singing-and-dancing extravaganzas, complete with synchronized dance steps and a troupe of scantily clad dancers. So we have Michael Jackson to thank for Britney Spears. Oh joy.

I'm sick and tired of the cult of artificial celebrity, which has reached its zenith with the enshrinement of so-called reality show stars like Jon and Kate and all those other losers who never accomplished anything in life other than acting out their pitiful lives in front of the video cameras. Michael Jackson was a talented performer, but nothing more. Let's not treat him as a god on his passing; let's not pay any more attention than that deserved by a has-been hitmaker with some very serious personality disorders. Michael Jackson, meet Frankie Lymon; that's your comparison, right there.

Enough is enough. That's much more than I ever intended to say about Michael Jackson, dead or alive, so I'll just stop now.

But that's just my opinion; reasonable minds may disagree.

One

It was just over a year ago that I moved to the Twin Cities, and shortly after that when I got married. That's two one-year anniversaries to celebrate and reflect upon, which I'll try to do here.

First, moving to the Twin Cities. I was a life-long Hoosier, not because of any great love for the place but mainly due to inertia. Central Indiana is an okay and extremely inexpensive place to live. The people are nice enough, although there's a decided lack of education and respect for intelligence among many. There's also little to no arts scene, and in Indiana, Republicans rule. So there wasn't much to miss when I moved, other than friends and family.

The Minneapolis/St. Paul area is definitely a much larger and more sophisticated metropolis than the Indianapolis area. Lots of great restaurants, a terrific music and arts scene, just a general big-city vibe that Indy aspires to but has never reached. The people up here are, perhaps, nicer than the folks in Indiana, although I suspect that what they call "Minnesota nice" is really just an advanced form of passive-aggressiveness; they're really nice to your face, but they talk a lot behind your back. Still, it's nice to be around nice people.

That passive-aggressiveness comes out in their driving, however. Nobody up here can negotiate a simple roundabout (not that there are that many up here, especially when compared to Carmel, Indiana, the roundabout capital of the U.S.). Half the time they enter the roundabout then stop halfway through to let someone from the outside in. I want to get out of my car (and I have time to, since traffic has come to a halt), pull them out of theirs, and beat their little pasty white heads against the pavement. I guess I haven't gotten into the Minnesota nice thing much, myself.

The arts scene in the Twin Cities is terrific. My wife and I have seen more music in the past year than I saw in a decade in Indy. They love and support all types of music up here, jazz especially, and the Dakota is the best jazz club I've ever seen. (Better even than Indy's Jazz Kitchen, which I still love.) In the past year we've seen Nanci Griffith, Brian Wilson, Booker T. and the MGs (twice), John Pizzarelli (also twice), James Hunter, Gordon Lightfoot, Manhattan Transfer, Irma Thomas, Ruthie Foster, Lura, and Sophie Milman. (There's so much good stuff up here, I get annoyed at the acts we have to skip because we can't fit them into our schedule.) All were good, but the very best were Brian Wilson and Nanci Griffith, both legends of their own type. Hearing Brian and his wonderful backing band do "God Only Knows" brought a tear to my eye, it was just so perfect. That moment alone made the move to Minneapolis worth it.

Of course, the real reason I moved to the Twin Cities was to get married. My wife Sherry came from Indy, originally, but has been living up here for the past twenty or so years. We've known each other since high school, but hooked up again about three years ago and did two years of very long distance dating. (I put a lot of miles on the old convertible...) I finally talked her into making an honest man of me, and so we got married a year ago April.

Married life is a bit of a change for a 50 year-old bachelor. Not only am I sharing my (new and bigger) house with my wife, I'm also sharing it with her dog, her teenaged son, and, during school breaks, her college-aged daughter. As an added bonus, her younger daughter is going through a divorce, and she and her two toddlers are also living with us. I originally thought a five-bedroom house would be overkill, but now I sometimes wish for even more room.

Room aside, I kind of like having a full house. I really like the grandkids, two year-old Collin and his one year-old sister Hayley. Collin and I are great pals, and he likes to do just about anything he sees me doing. Yeah, Sherry and I spend a lot of time babysitting that we could be spending doing newlywed-type stuff, but I wouldn't give up the time with the kids. After spending a half-century alone, I treasure every single minute with my new family. (For those interested, pics of the grandkids can be found here: Mike and Sherry's Family Pictures)

Sherry has one more child, a daughter who is married and living in Winona, about two hours away. (That's also where the other daughter goes to college, conveniently enough.) So there's one more grandkid in the mix, with a fourth on the way. I wish we could spend more time with little Alethia, but the distance precludes this. Again, I treasure the time we spend with her.

It's a big lifestyle change for me. Friends say I'm either a saint or a crazy person; I admit to the latter, but don't find anything wrong with that. It's a different life, but one I'm trying to live to the fullest. There's less private time, but a lot more love.

What do I miss about my previous life? My Indiana friends, of course. But also the little things, like Cajun food (none at all up here) and my old coffeehouse. During the month of May I tend to miss the goings on at the Speedway, but that hasn't been the same for a decade or more, anyway, so there's less to miss. I don't miss the thickheaded rednecks in my old hometown; I do appreciate the more liberal bent up here, as well as their great enthusiasm for all things social and political. (And Norm Coleman should just give it up and go home, already.)

All in all, it's been a good year. I hope to have many more with my new friends and family here in Minnesota -- and with my old ones in Indiana, too.

But that's just my opinion; reasonable minds may disagree.

Paul Harvey

The voice of Middle America is gone. Paul Harvey has passed away.

Like many listeners, I first heard Paul Harvey while on family vacations, interminably long trips to Florida or Colorado when I was a youngster. There is absolutely nothing good to say about the flat desolation that is Kansas, other than at twelve sharp you could turn the AM radio a few turns left or right and hear the voice of Paul Harvey. There was a dry stretch while I was in high school and college, but when I got older, I got hooked again, listening to Paul Harvey News & Comment when driving to lunch on almost every Saturday. At a still later date, Paul (along with the pre-merger XM Radio and old Bob & Ray CDs) kept me sane while I was long-distance dating my future Minnesota wife from my home in Indiana. It didn't matter where I was en route, Paul was always on some station somewhere.

I might have disagreed with his politics, but I appreciated the way he presented them. Instead of the bile and hatred that is right-wing talk radio today, Paul was decent and civil, putting his point across without viciously attacking those who disagreed with him. Rush and Sean and all the other blathering heads could learn something from Paul's honorable approach.

What I found most appealing about Paul Harvey was the same thing I appreciated about Johnny Carson. Both men had kind of a Midwestern decency about them. They may have hung out with movie stars and corporate bigwigs, but they didn't act like it or sound like it. Each of them seemed like the guy who lived next door, maybe a special uncle, someone who paid special attention to the old lady standing behind them in line at the grocery store. Paul and Johnny were just as interested in the couple celebrating their 50th anniversary or the old woman who collected potato chips as they were in the short-lived "celebrities" of the day. A true interest in everyone they met or read about, that's the common factor, and the ability to directly relate to their listeners and viewers. I miss that about both of these men.

I certainly will miss having Paul Harvey to listen to on the radio. Even though he wasn't there every day in the past few years (illness, old age, and the death of his wife cut into his schedule), noontime was always a little special when that booming voice came over my car radio speakers. I was always ready to "stand by for news," and my day wasn't good until Paul said it was -- with his trademark long pause. He may have been a product of another time, but there must have been something worthwhile about those days to produce someone as interested in and genuinely excited about human affairs as Paul Harvey.

But that's just my opinion; reasonable minds may disagree.

Mortgages

The whole mortgage crisis has me of multiple minds. On one hand, I'm not that hip on bailing out folks who made bad decisions and got in over their heads with overly-large mortgages. On the other hand, I'm also not that hip on forcing families out on the street and leaving large chunks of real estate to sit vacant in neighborhoods across the U.S. It's a damned if you do, damned if you don't sort of situation.

Excessive rhetoric by the media doesn't help things. In particular, there's little good to be said about the inflammatory comments by CNBC ranting head Rick Santelli about the Obama administration subsidizing the mortgages of "losers" and promoting bad behavior. Except, of course, that there's more than a little truth in the content behind the blather. Forget the tone and the source, and you're faced with the reality that it's the folks who screwed up who will probably get bailed out, while those of us who didn't (or haven't yet) screwed up have to keep paying our often-excessive mortgage payments. As a guy who has dutifully paid his various mortgages on time for the past twenty years or so, that kind of burns my ass. I play by the rules and don't even get a thank you note, while the bums who skip their payments get a hand out -- subsidized by me! Thanks, Big Government, for the appreciation.

On the other hand, I have much sympathy for those folks who either got talked into ill-considered mortgage products or who've recently lost their jobs and may soon lose their homes. Sometimes bad things happen to good people, and we should do something about that. I'd rather these folks get a little help than a boot out the front door.

On the other other hand, lots of folks who took out excessive mortgages really shouldn't have. They should have known they were getting in over their heads, whether we're talking lower-priced housing or a second McMansion. Sometimes it's okay to rent and most often there's little to be gained from trying to keep up with the Joneses. Some fools, rich and poor, deserve what they get.

But not all, and certainly not the folks we know, and most certainly not our neighbors. Thus the appeal of some sort of bailout for these mortgage holders. 

Still, I'm left with the feeling of being royally screwed by being a good on-time payer all these years. It's not that I begrudge the help to those who need it, but what about me?

This, I think, is the difference between insensitive blowhards such as Santelli and more reasonable guys like myself. Calling all families with mortgage problems "losers" is extremely unsympathetic to those who really are the victims of misfortune. I'm sympathetic to their plight -- I'd just like a little consideration for doing what I was supposed to be doing all these years. (And I'm also aware that anyone -- me included -- could have similar misfortune and need similar assistance in the future. There but for fortune, and all that.)

What I'd like to see is some sort of plan that helps everyone, not just those in default. I'm not sure what that would be, but I'd lean towards some sort of universal principal and/or rate reduction. (I'd be real happy refinancing at 4% or so, if anyone's listening...) That sort of plan would benefit those currently underwater as well as those of us who've played by the rules all this time. Yeah, and maybe a few "losers" too, but that's what happens when you cast a wide net.

But that's just my opinion; reasonable minds may disagree.

2008

The old year is past and the new year is upon us. Time to reflect briefly on the good things and bad things of 2008.

Bad things first, which include:

• The economy, the continuing military excursion in Iraq, the continuing encroachment on our individual liberties, and the ongoing enfeeblement of the press. Thanks, George W!
• Starbucks closing my local store. (And closing my former local store back in Indiana.) Not that I'm a big fan of corporate anything, but it's surprising how even a poorly performing Starbucks location forms its own tight community. My store is sorely missed not just by me (primarily for its convenient location) but, more importantly, by the regulars who made it their home. Home is where you find it, and dozens of people lost their home when the corporate office downsized.
• The "merger" of XM and Sirius satellite radio -- more accurately, a hostile takeover of my beloved XM by the smaller and less-successful Sirius. Gone are my favorite personalities, especially those on what was formerly my favorite XM channel, Soul Street: Bobby Bennett, Dr. Nick, and Leigh Hamilton. The late lamented Soul Street was, hands down, the best-programmed channel I've heard on any radio service, period, and it was criminal for Sirius to dump it so unceremoniously. Not only do I miss the DJs' expertise and intelligent conversation, the replacement channel (Sirius' Soul Town) leans too heavily on crappy 70s funk and not enough on the sweet 50s and 60s soul (including a lot of obscure tracks) that made Soul Street so great. Other favorite channels have also bit the dust, and the survivors seem to have shortened and more frequently repeated playlists. While I did pick up a few decent new channels (Little Steven's Underground Garage, The Bridge, and the real NPR), the "new" Sirius XM sucks almost as bad as terrestrial radio. I'm just glad I'm no longer driving 1200 or so miles a month, so I'm not forced to listen to this crap.
• The passing of some of my favorite public people. Chief among those these are musicians Levi Stubbs (of the Four Tops) and Isaac Hayes, actor Paul Newman, the legendary Bette Page, and author Donald E. Westlake, one of the most talented and prolific writers of any genre. They are all missed.
• Way too much snow in Minnesota.

Good things about 2009 include:

• The fall of the crony capitalistic dictatorship of Bush and Cheney and the election of Barack Obama. Of course, Obama inherits one of the biggest messes in history, but he's a smart guy who surrounds himself with smart guys -- a good start, at least.
• With the election of Obama, the notion that it's okay if not cool to be smart. I'm tired of this country's ignorance worship; it's time we looked up to those folks who actually know what they're doing.
• The Dark Knight and Iron Man -- finally, two really good comic book movies. (And I can't wait to see Watchmen when it releases later in 2009...)
• My favorite albums of the year, including the charming Volume One from She and Him (Zooey Deschanel and M. Ward); Brian Wilson's latest near-masterpiece, That Lucky Old Sun; Duffy's Brit-soul Rockferry; Shelby Lynne's tribute to the great Dusty Springfield, Just a Little Lovin'; and my personal favorite, James Hunter's infectious blue-eyed soul on The Hard Way. We had the personal pleasure of seeing both Brian Wilson and James Hunter in concert this year, and both were joyous experiences.
• Getting married to the love of my life and enjoying family life, including time with all my new step-grandchildren. (See my other blog for pics of us and the kids.) It was a bit of a change after 50 years of bachelorhood, but well worth it.

And that was my year, and my opinions. Reasonable minds, as always, may disagree.