Let’s show some slides, eh?

A few vacation snaps, because isn’t that what you’re supposed to do?

Everybody knows Sue, the T. rex at the Field Museum in Chicago. I tell Kate, “When I was a kid, T. rex were always depicted standing up on their back legs, like Godzilla. This is considered a far more accurate pose, based on analysis of the skeleton. More birdlike.”

Kate says, “Uh-huh,” as though nothing in the world could be more boring. Just once I want a kid who acts like she went to a private school, one of those little success robots with the firm handshake for adults and a reply that lets you know they’re paying attention to everything you just said.

Anyway, here’s Sue:

Sue

Alan notices something else about her. Her armature:

Sue's superstructure

“They could have used some crappy clamps, but this is sculptural. Look at the detail.” Each one of the vertebrae has a different attachment to the spine support. It’s simultaneously Victorian and modern, very cool.

Of course, that’s the Field, too — a place that honors the natural world by putting on display hundreds of dead animals. Signs here and there remind us it was a different world once upon a time, before television and hidden-camera technology. Seeing a stuffed wildebeest at the Field was the only way lots of people got to see a wildebeest at all. I think it’s a testament to the work they do that people still see wildebeests there.

I like the Lions of Tsavo myself. Those were some bad-ass lions.

Then it was up the Michigan coast for some beach time. True fun fact: Earlier this year I wrote a story on the tax incentives for making films in Michigan. A guy from the office that handles liaison work with Hollywood swears he has answered this question from California more than once: “Can’t you see Wisconsin from your side of Lake Michigan?” Um, no:

Lake Michigan, windy day

That was a pretty windy day. Lousy for kayaking. Alan, being a resident of the Auto Theft Capital of North America, knows how to protect his property:

Protecting one's investment

Sometimes people say, “Couldn’t a skinny person slide under the Club and paddle away?” I suppose so. But they couldn’t remove it without destroying the cockpit coaming. It’s all about making your stuff more complicated to steal than the next person’s.

Vacation, she is over. I tried very very hard not to pay any attention to the news beyond the important stuff. I ducked in and out of Facebook, just to make sure August is still the month where we care about what the First Lady wears to the Grand Canyon. I also tried not to write too much, just read and think. What I thought was…I should do some more writing. DIfferent writing, anyway. I say this every year. This year I should do it.

When we were in Chicago, we encountered European tourists, at least assuming that a knot of German-speaking people rolling their bags around hotel lobbies are tourists. On my sole trip to Paris in the ’80s I saw a poster in a travel agency, with the usual national icons touting trips around the world — the pyramids for Egypt, Great Wall for China, etc. For the United States, a cowboy rode a bucking bronco, surely a long shot for three days in Chicago, and certainly for a leaf tour through Vermont. What a big country this is; I never get tired of exploring it. I just run out of money.

So, what did I miss? More health-care debate? Meh. I kept up with that via my editing job, which continued through the week. (Long story.) And I thought about it a lot on Friday, when Kate’s mild earache turned into real pain, and we made a detour through an urgent-care center to learn what I already knew: She had an ear infection, and she needed antibiotics. As these things go, it wasn’t so bad — she saw a physician’s assistant, stayed out of the E.R., etc.; we must observe cost-control efficiencies — but once again, it semi-infuriated me. I still think it’s a very real possibility that our little family will be without health insurance within the next few years, because pals? Even with two college degrees, we cannot afford a $1,500 a month nut for health care. No matter what we cut, no matter what we sell. It can’t be done. That’s my personal bottom line.

So now it’s onward into the week, which, as is usual for post-vacation, too much sorting of mail and too little reflection on memories. Except here, maybe. So there’s that.

Bloggage? Sure: Roy on the National Review’s sudden fondness for long-distance psychoanalysis. Funny.

I did a little reading on this model-catfight-blog business, and I still think the most amazing detail is that someone managed to speak to an actual human being at Google, much less get them to reveal an anonymous blogger. They cancelled my AdSense contract, and I still have no idea why; I contacted them about a copyright theft and had to do the entire business through filling out forms. I’m not sure they even actually exist in corporeal form — I think the whole business is a hologram.

Oh, and the new season of “Mad Men” got under way in my absence. What do we think so far?

I think it’s time for breakfast.

Posted at 9:06 am in Same ol' same ol' |
 

60 responses to “Let’s show some slides, eh?”

  1. brian stouder said on August 24, 2009 at 9:24 am

    Vaca­tion, she is over.

    No kiddin’! It’s a cliche’ to say it – but my GOODness the summer went by quickly this year! This morning we took the young folks to the bus stop for the first day of school, and one little fellow threw such a fit that his mom and dad let him come back off the bus (tactical error, in our opinion, but always easier to say when it’s not your kid!)

    Speaking of the beach – I must say that I was completely won-over by Lake Michigan this summer. We went to the beach near Holland (I think it was $3 per car, for the state’s DNR), and it was as wavey and pleasant and warm as anyone could hope. The only other time I went to a Lake Michigan beach was many years ago in Luddington, and it was July and blazing hot – but the water was ice-cold! I assumed that it must all have been that way, but finally learned that I was wrong

  2. mark said on August 24, 2009 at 9:31 am

    Glad you enjoyed your vacation.

    Mad Men- Still great, but moving a little slowly for me. Last night’s episode was better, I thought. Did anyone else catch the teaser in the wedding invitation?

    Antibiotics- We ought to make the basic ones available over-the-counter. Many other countries do, and trust mothers to dole them out appropriately. I keep a small supply of a couple of favorite flavors and use them on the rare occasions when I think I might have an infection. No doctor visit, or expense, required. A few dollars for thity days worth in Vietnam or Thailand. Interestingly, I can get Vicodin (and related pain killers) over the counter there as well, though I don’t.

    If you are seriously worried about losing insurance, look into a catastrophic plan. Very high deductible, but you are covered if disaster strikes. I’ve had such a plan (and been uninsured) off and on over the last 10 years and it is very affordable if you are willing to take a $5000 or $10,000 deductible. Only burned once, when a minor surgery for a broken bone ran $4800. Aargh, but not a disaster. But that approach treats insurance as insurance rather than cost shifting/sharing. Still, it is an option that will let you sleep at night.

  3. Deborah said on August 24, 2009 at 9:48 am

    Mark,

    Not that I need it yet (I’m still employed although they had another lay-off while I was on vacation), how much do you pay per month for your catastrophic plan (if I may be so bold)?

  4. coozledad said on August 24, 2009 at 10:00 am

    I sort of have a ringside seat to all this “innovation” the Republicans yammer about (the same word was used frequently to describe mortgage backed securities, and many of the same perps are shilling for the insurance companies now). If by innovation, you mean looking for lab results that enable you to market therapies or drugs that have proven questionable or dangerous in the past, because you hold the patent for them and they are not currently bringing in rivers of cash, and that fantasy money is just chewing a bigass hole in your pocket, well there’s a shitload of “innovation”
    My wife used to work for the agricultural chemical industry. If they had a proprietary compound that was easy to make, but had no discernable agricultural purpose, they’d shop the rubbish to Pharma, who’d proceed to try and find some way to market it.
    Most of these companies that are steering actual innovation are foreign based multinationals whose home countries have a civilized system of medicine. Regardless, the cowboy/slut system that has evolved here suits their bottom line very well

    All that taxpayer money that has gone to State University basic research institutions is funneled directly into corporations that turn around and shake the patient down for his last dime. Essentially, some whore with an inside straight, say Joe Lieberman, is positioned to steer boxcars of that money his way, through his wife. By 2012, insurance costs will have doubled, and Americans will still be getting a shitty return on their investment. Lieberman will be torching his farts with Benjamins.

  5. mark said on August 24, 2009 at 10:06 am

    Deborah-

    About 170 per month. It varies a lot by state, health and deductible. I’m approaching 50, but height/weight proportionate and no substantial medical history/medication use. I did have to accept a pre-existing illness limitation for substance abuse since I used a rehab facility to kick booze a few years ago. For me that was no biggie since a) I still don’t drink; and b) most of the big name/big dollar treatment centers end up relying on some version of AA (which is free), so I wouldn’t go the treatment route again any way.

    There are lots of internet sites that will give you quotes (preliminary), if you are willing to receive a few phone calls.

  6. moe99 said on August 24, 2009 at 10:09 am

    http://www.google.com/hostednews/ap/article/ALeqM5jnC1WvFFoEh8QCl2kVJq2MCkOidQD99ST6600

    So current thought has it that with the current recession and jobs lost, 50 million of our citizens are without health insurance. AP offers a bunch of caveats above to be sure. But when will the ravening hordes be satisfied? Is 50 million enough to get serious about health care reform? Is $1500 a month for health care for a family of 3 too much?

    I submit that once you start to argue on their terms we’ve lost. The issue is, should health care, just like public education, be a right available to all US citizens? Why is healthcare any less important here than education?

    Added: the US ranks 29th in infant mortalityin 2004 according to a CDC press release last fall.

    http://www.cdc.gov/media/pressrel/2008/r081015.htm

  7. nancy said on August 24, 2009 at 10:12 am

    Mark, I don’t feel at all good about letting people buy antibiotics over the counter. You’re right — it’s funny how health-care tropes vary from country to country, and antibiotics are considered children’s aspirin in one place but not another. T.R. Reid did one of those health-care-around-the-world pieces for “Frontline,” and discovered Japan loves MRIs, CAT scans, etc. You get an MRI for a head cold in Tokyo.

    That said, overuse and misuse of antibiotics is one reason so many infections are resistant today. One fascinating fact I learned after I moved here (and have mentioned here in the past — sorry) is that for decades, it was taken as a given by Detroit junkies that if you mixed antibiotics with your heroin, you’d be protected against hepatitis, HIV, etc. As a result, Detroit has some major drug-resistant bugs. (Story here.)

    That said, I would have welcomed OTC antibiotics this weekend. The whole thing reminded me of the old yeast-infection merry-go-round of the ’70s and ’80s, before Monistat came out of the pharmacy department.

  8. mark said on August 24, 2009 at 10:23 am

    nancy-

    You are right, I think, about the overuse and it’s consequences. But we have done that with doctor intervention. We have to quit expecting a 24 hour solution to every 48 hour sore throat. I’m too old to change my own body chemistry, but I won’t use them unless I think it is something pretty nasty.

    An angle of the healthcare debate not covered is the huge disproportionate use of medication in this country. If Obama thinks we are global energy hogs, we are far worse on pain-killers, anti-depressants and, yes, anti-biotics. Maybe it does makes us all healthier, but it costs a fortune in addition to the problems you mention.

    I was taught years ago that 90% of all illnesses are self-limiting; thery will resolve the same way, eventually, with or without care. That could be wrong or maybe things have changed. But I think in part we are just too impatient to suffer through a cold.

  9. whitebeard said on August 24, 2009 at 10:33 am

    In my neck of the woods while you were away vacationing, journalism ethics were sadly bruised when a newspaper consumer watchdog had his position terminated and within hours after his final afternoon on the job “fired” up his very own http://www.ctwatchdog.com website with the help of some friends.
    And then it mushroomed into an article in the New York Times, an Associated Press story which appeared in newspapers across the country, a CNN video, radio broadcasts and an Internet blogplosion.

  10. nancy said on August 24, 2009 at 10:35 am

    Please don’t put the explosion in prescription drug use entirely on patients. Spare a little blame for the pharmaceutical industry. During my fellowship year, that was the one thing guaranteed to drop jaws among our overseas fellows — the sheer amount of drug advertising they saw. (You should hear a guy with a Turkish accent describe one: “The man is running on the beach with a golden retriever…This you would not see in Turkey.”) And that can be directly correlated; the year it became OK to advertise Allegra, et al on TV was the year script-writing exploded. GM’s health-benefits people can tell you when a new ad campaign starts, just by tracking their payouts.

    As for painkillers, google “purdue pharma” + oxycontin + “$600 million” + felony for a little background.

  11. mark said on August 24, 2009 at 10:58 am

    I don’t want to tear the fabric of the universe with too much agreement, but I agree. I don’t know why we let the pharma companies advertise controlled substances. And on a somewhat related note, my brother, a chemist/project manager for Lilly, is increasingly distubed that he seems to be forever tasked to the “big” growth area- developing new, “cool” dispensing devices for insulin. Not improving anything in any substantial way, but making the devices look and act more trendy, so that they will be preferred the way kids prefer one cell phone over another.

    Diabetes is the big money maker of the next decade, or so he is told. Getting the ever younger diabetic crowd to prefer your insulin over the other guys identical insulin is a multi-billion dollar issue. He jokes that he is looking for a device that will store a 30 day supply, has a variety of interchageable color covers, and will hold 3000 downloaded tunes.

  12. Dorothy said on August 24, 2009 at 11:02 am

    A sore throat is not necessarily an infection and therefore does not need to be treated with antibiotics. It could just be a virus. This is the main reason why antibiotics should NOT be over-the-counter available to every Tom, Dick and Mark. Doctors go to medical school to determine the difference between a virus and an infection. End of story.

  13. Danny said on August 24, 2009 at 11:06 am

    Yeah, agreed about the antibiotics. People will abuse them.

    And the drug commercials are weird. With all the disclaimers about possible doom-and-gloom side effects. Don Draper is miffed. And my wife and I wonder if tandem clawfoot bathtubs come with the purchase of a modest amount of Viagra or what.

  14. Danny said on August 24, 2009 at 11:18 am

    Hint: Brian, click the model-catfight link. It’s a good .. um.. story.

  15. 4dbirds said on August 24, 2009 at 11:38 am

    “I sub­mit that once you start to argue on their terms we’ve lost. The issue is, should health care, just like pub­lic edu­ca­tion, be a right avail­able to all US cit­i­zens? Why is health­care any less impor­tant here than education?”

    I say health care for all Americans ranks right up there with national defense. I’ve read that most uninsured work. Therefore they are paying taxes. Taxes that subsidize all of us who pay for our employer based insurance with pre-tax money. The working uninsured also pay taxes for government and corporate medical research that they aren’t able to access.

    I have three tax-paying adult children who are sans health insurance. Two years ago one of them injured his hand. A hand he needs to make his living. While the ER stabilized him, needed surgery to correct the actual damage was not offered and we had to pay 4000 up front for any doctor to touch him. His dad and I had just finished paying closing costs on our house so we were tapped. My mother ended up paying the bill so he wouldn’t be permantly disabled. High deductable insurance would have been worthless.

    Our system sucks. We do not have the best healthcare in the world and if the other side wins this, nobody wins.

  16. Sue said on August 24, 2009 at 12:07 pm

    I’m a little shaky on these thoughts, so I’ll place them as questions and wait for your thoughtful answers:
    1. My neighbors have both lost their jobs in the last three months. They can get health care through their former employers for awhile, but have done some big-picture research and applied for insurance with three carriers. They were turned down by all three due to high blood pressure and weight issues. They are younger than me, probably mid-forties. The weight issue is hilarious, given that this is Wisconsin and they don’t look any different than 3/4 of the adults in the state. Why is a public option losing ground on a “competition” argument when there seems to be a compelling argument for insurance availability to those the companies refuse to serve?
    2. How, exactly, are you supposed to get it on in uncomfortable, his-and-hers clawfoot tubs? Why is that a selling point? And how are you supposed to sell drugs on tv when most of your commercial is devoted to telling you how the drug can kill, maim or permanently disable you? Hearing that I might commit suicide or have my liver explode while taking a drug does not make me want to rush to my doc’s office and demand a handful.
    3. Is anyone else drawing a parallel between Bush’s evangelicals and Obama’s liberals/progressives? Necessary to get elected but easily ignored afterwards? If we can’t get what we want with someone like Obama, or should I say can’t get even a little of what we’re asking for, what’s the point of voting mid-term or next presidential election? Bush’s evangelicals stepped up to the plate repeatedly; Obama’s liberals won’t, I think.
    4. The only thing I have to say on over-prescription of drugs is that anti-depressants are probably overprescribed because insurance companies balk at paying for other forms of psychological therapy – too expensive, too long-term. So what’s left? Drugs.

  17. LAMary said on August 24, 2009 at 12:18 pm

    It’s Cialis that sends you the bathtubs, Danny. Viagra sends you on a trip to a private island.
    When my first son was born, there were several other women in the neighborhood who had babies. One was an infamous germ-phobe. If her kid so much as sneezed, she was on the phone demanding antibiotics, and damned if her pediatrician wasn’t writing her the scrips. She also kept her kid from contact with other children, playgrounds, touching any surfaces with his hands in public places. That kid was sick all the time. He wore sunscreen 24 hours a day.

  18. Sue said on August 24, 2009 at 12:33 pm

    I was one of those sort-of-germphobe moms, only without the calls to the doc. I came by my behavior for two reasons – I worked in a hospital surgery department so was naturally careful, but more important, I was surrounded by moms who couldn’t/wouldn’t teach their kids to blow their noses or wash their hands. My kids weren’t sick all the time nor were they overly protected, but by gosh I was disgusted by all the hacking and spraying of snot going on around me.

  19. beb said on August 24, 2009 at 12:57 pm

    I never get tired of explor­ing it. I just run out of money That is an “Amen!” comment.

    Michelle Obama’s shorts. The headline called them “short-shorts” but they come half way down her thighs, that’s pertty much standard shorts to me. Short shorts would be pants that barely cover the ass. So right off the bat the media is lying about how she dressed.

    Antibi­otics– We ought to make the basic ones avail­able over-the-counter
    Bad, bad, idea. How do you think those super-viruses are created? Through the too frequent use of antibiotics. It’s evolution in action. By killing off most bacteria the survivors, the antibiotic-resistant strains grow to dominate the field.

    . . . devel­op­ing new, “cool” dis­pens­ing devices for insulin
    I’ve been resisting a switch from pills to treat my diabetes to insulin because I hate shots. If Big Pharm can find some way to deliver insulin without shots or without so many shots they will have invented “the better mousetrap”, the world will beat a path to their door. Of course, if what they want is some way to make their insulin sound like better insulin because it’s in a blue package, then to hell with ’em.

    Yes, what is it with the bathtubs in the cilalis commercials. I assume this is a way to suggested mutual nakedness, the first step to intercourse, but I get confused whether cialis is for weak dicks or leaky plumbing, the other heavily advertized drug.

    There is one difference between Bush Evangelicals and Obama’s “left of the left” supports. Bush’s base never reared up and snapped at him. Obama’s base are a host of bloggers who aren’t afraid to call him out for weakness, being a closet consevative and being too obsessed with bipartisanship. Bush could ignore his base, Obama ignores them at his own peril. Unless Obama grows a spine there’s a good chance he will see a serious challenge in 2012 by a “better Democrat.”

  20. Danny said on August 24, 2009 at 12:59 pm

    …but by gosh I was dis­gusted by all the hack­ing and spray­ing of snot going on around me.

    Ah, the pastimes of the dairy state.

  21. kayak woman said on August 24, 2009 at 1:04 pm

    Gorgeous shot of Lake Michigan! I have answered that annoying Californian question “can you see the other side” many times although Superior is “my” great lake.

    Strongly disagree with making antibiotics an over-the-counter drug! Yes, people *will* abuse them. Already do!

  22. Danny said on August 24, 2009 at 1:23 pm

    Regarding the “see the other side” question at the Great Lakes: Wow, I didn’t realize that anyone would ask that question. I guess it shouldn’t surprise me though because many native Californians are probably unaware of life east of I-5. Recently, the daughter of a friend asked where Washington D.C. was located. She’s a senior in high school.

    My theory is that many Americans don’t know the geography of an area until we bomb the place.

  23. John said on August 24, 2009 at 1:24 pm

    I never got the whole his ‘n her bathtubs. I prefer one big tub with plenty of room for some serious back scrubbing. And Beb, I do enjoy mutual nakedness a lot. Lots of fun without the physical exertion. Euphemistically, I can spend a lot more time walking around the track rather than running a 400m.

  24. mark said on August 24, 2009 at 1:36 pm

    Beb-

    Good news ahead for you. Lots of new stuff coming, but at a cost. My brother works off and on with a project to provide aerosolized insulin through an inhaler, similar to that used by asthmatics. Some versions may be on the market now. The “stick pen” is already out and supposedly less painful/intimidating. Still, the push is to up the cost (through the new form of delivery), not lower it. The evil insurers prefer the old needle, becaue it is cheapest and effective for almost everybody. They seem to think it lets them cover more people at less cost.

    Viagra/Cialis- another drug that should be available over-the-counter. Talk about needless/fraudulent doctor visits and prescriptions.

    sue- interesting point about the differing “bases”. Reagan and Bush 1 and 2 never wasted any capital on the evangelicals that I can recall. But they stayed reliable. I think Obama is more of a true believer, but who knows. The libertarian wing of the conservatives would happily trade healthcare reform for gay marriage or “don’t ask to not tell”.

  25. 4dbirds said on August 24, 2009 at 1:57 pm

    Mark, “I’m glad your son got his surgery” Bless your heart, now we know you don’t care so quit lying. Perhaps I would have more money set aside if I hadn’t been dealing with my daughter’s childhood cancer and the late term effects of the treatment. Plus your little dig “It doesn’t pro­vide a claim on other people’s money.”, perhaps you didn’t read my post. Anyone who gets to make pre-tax payments on their health insurance premiums is getting subsidized by the tax-paying uninsured. If that is the case with you, you are making a claim on my son’s money. Yes everyone should an extra 5000 to 10,000 just sitting around for emergencies. I agree but you know what, most don’t. That’s what insurance is for and that’s why everyone should get it.

    Beb, don’t be afraid of the shots if you have to go there. I’ve been on insulin for years. The needles are thin and you can even get the extra short kind. I get my my needles from VA and they don’t offer the extra short kind (that horrible horrible socialized medicine denies me an expensive needle. The humanity.) but I rarely feel an injection. I inject in the tummy area.

    EDIT: Not quick enough Mark, saw your pre-edited post.

  26. LAMary said on August 24, 2009 at 1:58 pm

    Sue
    I was always a handwashing nazi with my kids. I still have to be with the fifteen year old. Since they both ride mass transit alot, they both have hand sanitizer in the backpack. Older son uses it, younger son misplaces it. My kids are not sick very often, but the older on did develop asthma after catching a flu/pneumonia combo when he was seven, but he seems to have outgrown it.

  27. mark said on August 24, 2009 at 2:02 pm

    4dbirds-

    My apologies. Your personal experience was inappropriate for me to use to make a point that did not need to be made in any event. I edited the comment, but apparently did so while you were formulating your reply.

  28. Jeff (the mild-mannered one) said on August 24, 2009 at 2:10 pm

    Conversation with a licensed pharmacist about medical ethics, circa 1986 — “and i’m worried that we’re allowing doctors to advertize; everyone knows that it’s a serious breach of ethics for pharmaceutical companies to run advertizing with the general patient populace.”

    I’ve often wondered what that pharmacist thinks today over the last twenty+ years.

    Health care as a right strikes me as does the saying, popular in my usual circles, that housing is a right. I usually shock and dismay folks by disagreeing — and i’m probably the best known homelessness advocate in this region. But in a constitutional democracy, when you start making specific economic sitations rights-based, you open up a very messy can of worms that don’t squirm where you think they will.

    Actually, i think there’s a better case for arguing that “health care, as defined in the following statement, is a fundamental right of our citizens,” but i don’t know how to write that subsequent statement. We have implicitly made access to emergency treatment a right in this country for the last 24 years, and we’re looking at saying that’s not quite good enough. I’m in for that conversation, but not up for saying that equality of health care is a national necessity . . . and calling, in our system, for health care to be a right implies that it will have to be equal.

    And i’m skeptical that pulling down the quality of care for most is the best way to provide basic care for some, purely on pragmatic grounds. Ditto making housing a right, which then starts to open up debates over rent-control, minimum acceptable standards, and enforcement, that all pushes the debate past the fact that we were trying to ensure that no crisis could put anyone person or family beyond the reach of an emergency shelter/transitional housing plan.

  29. moe99 said on August 24, 2009 at 2:16 pm

    Good, basic health care is a right, Jeff. It’s in the defining that things go hinky. I’m not adverse to letting folks but gold plated policies to cover themselves, but my son who lives in RI now and is just starting his first job, may never get the surgery he needs on his foot because he was too busy this spring because of college graduation to get it done before he left the family policy. It could be considered a pre-existing condition.

  30. Jeff (the mild-mannered one) said on August 24, 2009 at 2:17 pm

    Moe, fair enough — but it’s the”is” in “is a right” that makes me stop and think. How, legally, are we really intending that to work? It sounds very appealling, but like “food is a right” and “self-esteem is a right” and “the right not to be bullied in school,” those are all principles i agree with personally, but am not sure i want to work through as legal concepts alongside “life, liberty, and the pursuit of happiness.” The more i invite government to decide what foods or amounts thereof constitute a civil right, the more i’m affirming governmental control over those areas. It’s like why i’m not for a journalistic shield law — when you let the government protect reporters’ use of sources, you let them implicity decide who is a reporter . . . and who isn’t.

    Defining “basic health care as a right” in some degree up from ER access we at least agree on — hooray! How far that goes . . . it’s going to be tricky. Conservatives joked about cheeseburger & potato chip taxes, and now we’ve already got folks saying that should be central to “meaningful health care reform.” Oy.

    I’ve wondered all summer — when did shorts get so long? My shorts, all three pairs, are apparently short shorts, and in fact, i had kids tell me that, as they gamely tried to help me avoid fashion faux-pas-isms, as they stood politely telling me this in their shorts that looked, for all the world, like high water baggy pants.

    Maybe this was trending last summer and i was only doing camp with 3rd and 4th graders who weren’t likely to try to fashion counsel a camp counselor. Anyhow, i’m baffled that anyone has even a half an observation to make on Michelle Obama’s vacation garb. Go comment on the costume design for Mad Men already . . .

  31. MarkH said on August 24, 2009 at 2:31 pm

    beb – 4dbirds is right. My 20-year-old son has been a diabetic for 19 years, and has used all methods of insulin delivery at one time or another, needles, pens and pumps. Insulin injection is all subcutaneous, so the micro-thin short needles work great. This pump (his current one) is the best delivery system short of a beta cell implant, and features a monitoring system as well.

    http://www.myomnipod.com/

    He goes on the pump for a while, but tends to revert back to needles, as he is very active and attaching the OmniPod (or wearing another type pump) can be cumbersome. The inhalers mark mentioned are still way in the testing stage, mostly due to the imprecise dosing. But, wow, what an easy way to go when fully sorted and developed. Our family is excited about what’s ahead for type 1 management.

  32. Julie Robinson said on August 24, 2009 at 2:33 pm

    Conversation a few years ago with my sister, who works for the WIC program in tony Palm Beach County. Me: The economy is so good, I don’t understand why these people don’t just get jobs. Her: They have full time jobs, but don’t have any health insurance. Me: What kind of jobs don’t have health insurance? Her: Most of the men are gardeners and most of the women are maids and nannies for all the rich folk around here. Me, penny finally dropping: You mean my taxes are subsidizing them so that they don’t have to offer health insurance?

    It is inevitable that someone will have to pay more for everyone to get coverage. As proposed, that would be the wealthy. What we have right now is the middle class paying for both the some of the poor and the rich, and a lot of people getting no or lousy care. Our nation has sadly failed the Hubert Humphrey test of how a society should be judged: “by how it takes care of its youngest, oldest, handicapped, sick and disadvantaged”.

  33. paddyo' said on August 24, 2009 at 2:37 pm

    “Mad Men” wedding invite teaser, Mark? It was brilliant … I think I heard it first in the dialogue, and then that close-up of the invite itself sealed it. Can’t wait for THAT one to come around …

    Also, a friend wondered in a post-Episode-2 e-mail last night why Peggy hadn’t yet discovered The Pill in her roll-around with the boy from the bar — and thought, hmm, maybe it wasn’t available then? Apparently it first became available in 1960, and in somewhat improved form the following year, but not in every state until 1965. Of course, “available” and actually “in use” for our Peggy are different things, I suppose . . .

    I agree that it’s been a little slow so far, but Don’s bit of take-charge on the matter of his Alzheimer’d father-in-law (and taking his pipsqueak brother-in-law to the woodshed over it) was most excellent, if “only” domestic. I loved his angry face-off with the Brit boss of the ad agency, too, over London’s clueless withdrawal from the Madison Square Garden account. Lots of subdued but rich stuff going on in the offices right now . . .

  34. Jeff Borden said on August 24, 2009 at 2:46 pm

    After watching the unctuous Joe Lieberman, who enjoys the highest caliber of health care available by virtue of his station in life as a U.S. Senator, suggest that we just not hurry into facing our health care problems, I wanted to puke. It’s easy for him to say.

    I continue to view health care as a vital component to our national economy. We spend too much to get too little. Once, I was naive enough to believe corporate America would be the driver of health care reform. We all have heard how health care expenses (and, to be fair, pensions and retirement plans) add thousands of dollars to an American-built car. Wouldn’t a form of national health care make the Big Three more competitive on price? And what of the would-be entrepreneurs who fear taking that step because they would forfeit whatever health care they are currently receiving?

    We absolutely need a robust debate on what and how to approach this mess. What we do not need are fools who label those who recognize the problem as Nazis or fans of euthanasia or socialists.

    I will soon be in Nancy’s position as my wife is older than me and would like to retire in two years, when I will be well short of eligibility for Medicare. Since I piggyback on her bennies, I will be out in the cold and facing the same kind of budget-crunching expenses. This is not a partisan issue for me, but a very real conundrum that will hit me a lot sooner than I’d like.

  35. mark said on August 24, 2009 at 3:00 pm

    If we want to take care of those who need help and not bankrupt the country in the process, then we will ultimately have to apply a means test to all of these benefits. FDR resisted this with social security because he feared it would be stigmatized as welfare and thus defeated. He was probably right but I question whether such a stigma exists today. Cash for clunkers was welfare for new car buyers and it didn’t slow the sales.

    If I were king, I’d let people cover the first x dollars of annual medical expense, up to 7% of their AGI (above, say, the first $10,0000), then have insurance or government take care of the rest. The poor would pay nothing or a very nominal amount, the rest of us would have to budget, just as we do for homes, cars, vacations, insurance premiums, etc. But the majority would still have an interest in making cost-effective decisions rather than viewing everything as free or a right.

  36. ROgirl said on August 24, 2009 at 3:05 pm

    The United States spends more on health care than every other country in the world, yet for industrialized countries we’re last in preventable deaths, low in life expectancy and have a high rate of infant mortality. Then there’s the poor quality ratings (meeting patient needs, patient safety, treating chronic illness) and we are, of course, the only major industrialized country that doesn’t provide universal health care coverage.

    A lot of the spending here is due to administrative costs.

    I’m on COBRA now, thanks to the premium reduction that went into effect earlier this year. It’s supposed to expire soon, and I don’t know if I’ll be able to cover the cost of my monthly premium when that happens.

  37. 4dbirds said on August 24, 2009 at 3:06 pm

    In the past 20 years my immediate and extended family has seen almost every worst case healthcare scenario. Because of this I am so passionate about reform. We had a child with cancer and found that even though one can be ‘cured’ the late term effects go on forever. Trips to doctor, medications, surgeries and mental health care will eat up every disposable dime of our income. Once we went through the 5000 to 10,000 in emergency funds that “everyone” should have, we ended up spending our other’s children college money and then using credit cards. We actually got to the point where it became our normal and we bounced back a bit.

    A few years ago my oldest sister was diagnosed with breast cancer. Shortly after her diagnosis her employer went out of business. Since there was no employer anymore, there was no COBRA. She had cancer and no insurance. Her cancer was particularly aggressive and her treatment left her too weak to find another job. She owned a home and had the majority of her money in her 401K and IRA plans. My sister was single and never had children. She was a good saver. She’d worked all her adult life and paid her own way through the University of Maryland. So for a year she went to Johns Hopkins for her chemo, radiation and any subsequent hospitalizations due to infections or other problems. She paid them in cash from her savings. Although unemployed she had a house and some savings so she didn’t qualify for any assistance. Did you know one bag of chemo is a thousand dollars?

    After a year of this, she was worried she’d run out of money and was afraid she’d lose her home. My husband and I offered to buy her home so she could get the equity and we would ‘rent’ it back to her as she had now qualified for Social Security disability and had at least enough coming in to pay us rent. Her equity would continue to pay for her treatment. That was the house we had closed on when my son had his accident and I didn’t have the extra money to pay for his surgery. According to some, that was irresponsible of me. My son, a married college student with a part-time job was irresponsible because he hadn’t saved enough and his wife’s pre-existing condition made private health insurance too expensive to buy.

    My sister didn’t win her fight and she passed away. I’m still glad we bought her house because it gave her such peace of mind. With the downturn in the housing market, we’re upside down (no good deed go unpunished) but we have a renter and we come out even with rent/mortgage payment.

    Sorry I didn’t plan ahead for all that. I didn’t plan for my kid getting hit by a car either. I didn’t plan for another relative who needed thousands of dollars in dental work, but I helped out anyway. I’m not saying any of this to have anyone feel sorry for me or to whine. I love these people and I will help whenever and wherever I can. My husband and I worked our jobs through all of this, we were lucky we had jobs that have good insurance.

    I guess I’ll always be a Pollyanna who thinks every American should be lucky and have affordable healthcare so they don’t have to lose their homes, or go bankrupt or settle for a lifetime disability. No system will be perfect, as Mark says some people will have to budget but so many people are shut out right now.

  38. moe99 said on August 24, 2009 at 3:31 pm

    the birthers have a new trick up their sleeve. Can’t wait to see if Palin, Bachman, and others of their ilk jump on it:

    http://crooksandliars.com/david-neiwert/now-birthers-are-demanding-know-was

  39. Connie said on August 24, 2009 at 3:31 pm

    I’ve been using the insulin stick pen, actually called a flex pen for several years now. When other diabetics ask me – with amazement – why I am not taking Lilly’s humalog – the answer is because back in the day when they were refilled with cartridges rather than disposed off, the other brand was the only one my doctor had free units of to give away.

    As an employer I can tell you about health insurance. Current rate here is $550 for single employee. Double that for employee plus spouse OR employee plus kids. For a family with employee, spouse, AND kids figure just under triple that. That will buy you a pretty basic 80/20 Blue Cross plan with $20 copay and 10/20/30 prescription coverage.

    If you are covered by health insurance and are going to lose it due to job change or loss don’t forget to ask for your official certificate of coverage. It is my understanding that if you take your certificate to a new insurance plan within 6 months you will still be covered for pre existing conditions. This is one of those little benefits due to COBRA.

  40. Sue said on August 24, 2009 at 3:35 pm

    Thanks 4db for sharing. Your experiences are a perfect storm version of what many of us worry about in our “what if” 2 a.m. insomnia sessions.
    MMJeff: “access to emergency treatment”? Not really, judging from some signs I have seen in emergency room waiting areas, which spell out rather bluntly that if you do not have insurance and cannot cough up the bucks, you are entitled to be stabilized before being discharged. I do not call that emergency treatment.
    Edit: Moe, just read your comment. OMG, yay! I really, really, really want to be at the press conference when Obama says “Scuse me while I whip this out!” Maybe he could do it at a bill-signing or something. Oh, please all-the-powers-that-be,let it happen…

  41. jeff borden said on August 24, 2009 at 3:40 pm

    Moe,

    Weird. The last episode of “Seinfeld” I saw involved Elaine hiring a manic-depressive mohel to perform a circumcision. Today, I read that the latest outrage among the Freepers is whether President Obama has been circumcised. The crazy is being cranked up way beyond ’11’ these days.

    An aside: Has anyone else heard that Arthur Frommer the travel guru is refusing to visit Arizona or recommend it as a destination because of all the gun-toting folks showing up at the O’man’s events? He says he wants to study the situation in Arizona further, but finds it troubling that people are walking around with assault rifles slung over their shoulders and 9-mm pistols on their hips in public places.

  42. nancy said on August 24, 2009 at 3:45 pm

    Insulin inhalers have a way to go. One of the big pharmas just abandoned their program in development, for several reasons, but the most obvious — and most amusing — was that it looked very much like a bong. People think “inhaler,” they picture “small and palm-able.” But these suckers required you to perhaps sit there in public and hit it like you’re back in your freshman dorm room.

    Also, inhaled insulin is imprecise, dosage-wise. One of my friends here has a pump, and loves it. Pancreas in a pocket, they call it.

  43. Colleen said on August 24, 2009 at 3:52 pm

    I guess I’ll always be a Pollyanna who thinks every Amer­i­can should be lucky and have afford­able health­care so they don’t have to lose their homes, or go bank­rupt or set­tle for a life­time dis­abil­ity. No sys­tem will be per­fect

    Yes. This.

    And most people I know without insurance are working. It’s just too expensive for their employers to offer insurance.

  44. Scout said on August 24, 2009 at 3:56 pm

    4dbirds – I so admire your selflessness. Every word of your post needed to be said because in the abstract, it is easy for the other side to frame the debate as between the “lazy” and the “productive.” Clearly, that is not always the case, as your stories so brilliantly illustrate.

  45. 4dbirds said on August 24, 2009 at 4:03 pm

    Thanks Scout. My sister was anything but lazy and non-productive. She was a RN who specialized in healthcare IT. She was in the Public Health Corps for many years and held a reserve commission in the navy. Even in her last days she made sure her bills were paid. At her last appointment with her doctor (the death panel) when she and the doctor decided she should go into hospice care, she joined one last study where after death, her cancer cells would be collected for breast cancer researchers.

    EDIT: My sister also insisted I join a study “The Sister Study” which follows the sisters of breast cancer patients to see if there are any trends, etc.

  46. moe99 said on August 24, 2009 at 4:46 pm

    4dbirds: I’m doing that study too.

  47. MarkH said on August 24, 2009 at 5:05 pm

    Nance, see my post #31. As with anything new and in development, the first versions are large, cumbersome and not practical. Once they have the technology, they can work on miniaturization. You were talking about Lily in your post, and you’re right:

    http://www.diabetesnet.com/diabetes_treatments/insulin_inhaled.php

    Those suckers are huge. But they are also putting faith in a lung inhaler, as opposed to the nasal inhaler. They have already produced a palm-sized version, as the linked page shows.

    The OmniPod I linked to in #31 is a fully self contained pump, complete with a retractible needle, no canula, and no insulin line dangling around. It sticks to the skin at the site and is more unobtrusive than conventional pumps.

  48. jeff borden said on August 24, 2009 at 6:23 pm

    (Sigh)

    Maybe after we officially determine that Barack Obama is not a Kenyan-born, Nazi racist Muslim socialist with an uncircumcised dick our august Congressional representatives will finally settle down and deal with the health care issue.

  49. LAMary said on August 24, 2009 at 6:34 pm

    My significant other, the In House Brit, is not insured by his employer. He finds the objections to health care reform ridiculous since he is very familiar with the NHS in UK and has no significant complaints about it. One nice thing about all the nut job objections about death panels and my personal favorite, “People such as scientist Stephen Hawking wouldn’t have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless,” is that I’m hearing from UK friends. They wonder what kind of idiots we are harboring here.

  50. alex said on August 24, 2009 at 7:17 pm

    Re: moe @ 38—

    Well, Obama did use the cryptic words “wee-wee’d up” to describe some of his critics. And Robert Gibbs is quite, eh, circumspect as to its meaning. Perhaps the administration was tipped off that Petergate was about to go viral.

  51. brian stouder said on August 25, 2009 at 12:13 am

    Danny-14; I didn’t understand the article, but I loved the shot of the one woman’s cleavage.

    As for the rest of the political stuff – my view is that President Obama ran on a platform of change; and he won on that platform.

    If he is Lincolnian, then the change he might have intended was a change in tone; a cooling of passions and a fresh effort to honestly work with as opposed to determinedly against the minority party. All this (seemingly feckless)deference to the GOP looks to me like some quite understandable, truly intended outreach for consensus.

    And if the minority reads this as weakness and becomes all the more adamantly determined to oppose/obstruct/destroy anything and everything that the president tries to do, then a student of American history such as President Obama probably won’t be surprised.

    But indeed – history will record that the effort was sincerely made; and then, when the Democrats finally put together their coalition and roll over those people, the Republicans can cry all they want, but they will have missed the train.

    And – if the Democrats DON’T coalesce, then (for example) Blue Dog Democrats such as Evan Bayh here in Indiana (a state which the president carried) might find themselves dumped in the countryside.

    I think I’d sooner vote for a Republican-in-name, than one of these Blue Dog Democrats like Bayh, if ol’ Ev humps Indiana’s leg and then looks for a reward.

    That dog won’t hunt.

  52. crazycatlady said on August 25, 2009 at 12:16 am

    beb is married to a nurse!! When he says he’s resistant to use insulin, it means he flat out refuses!!! I could do it all for him. But no. So i guess I’ll be taking care of it later, after he loses a foot or goes blind…..

  53. velvet goldmine said on August 25, 2009 at 1:22 am

    Nance, If your insurance situation goes Defcon One before there is any real reform, have you looked into AARP? I think you already mentioned that they’ve “found” your household. My husband is eligible, although only 51. We still can’t afford what they offer (he’s self-employed and I’m getting increasingly unemployable because of a frozen shoulder for which I have no insurance to fix it…. usual American ballad) BUT it’s far from the $1500 you mentioned. I think it was about $400 to cover the two adults, two kids in the family.

  54. derwood said on August 25, 2009 at 7:59 am

    Pfizer dumped their inhaled insulin because of cost to the patient. That and it did look like a bong. Indy based pharma company dumped theirs not to long after Pfizer. Theirs was much smaller and looked more like an Asthma inhaler. Cost to the patient was again the issue. They couldn’t convince doctors to write the scrips for something that was 4-6 times the cost of syringes and bottled insulin.

    My wife has been a Type I for 24 years and currently uses a pump. She loves it. She transitioned from syringes to the flex pens to the pump.

    From her perspective she has said she would not trust an inhaled product. When you eat you need to bolus the exact amount of insulin to cover your carb intake. She is not convinced that inhaling insulin and having half of it hit your tongue or the back of your throat is going to get the correct amount into your system. Where if you inject using whatever deliver system, you know you are getting x number of units.

    d

  55. Julie Robinson said on August 25, 2009 at 8:33 am

    Velvet G, have you been to a physical therapist? I had a frozen shoulder and incredible pain after falling on the ice at work. I did see an orthopedist, who x-rayed and gave me a shot for the short term, but then referred me to PT, which is where the real healing work was. He taught me easy exercises I could do at home without special equipment, got me out of pain, and gave me hope for the future. Even without insurance you can self-refer and it would be a couple of hundred dollars. I know that may sound like too much money, but I had another pain situation that I ignored too long, and it will be with me for the rest of my life. I learned my lesson on that one–it’s much cheaper in the long run to address it early. Plus, pain is no fun and limits your life.

  56. Jeff (the mild-mannered one) said on August 25, 2009 at 8:48 am

    So, given the consensus around universal coverage in the neighborhood, can i ask a different question? Do folks prefer a comprehensive single payer applied benefit to all citizens (i.e., socialism, but i mean that in the nicest way possible), or federal/state mandates to require insurance (like auto liability/collision to have legal registration/license) along with a broadly available public option, and a pool national plan for those uninsurable for pre-existing conditions and other insurability barriers?

    Because the problem with the latter approach is what to do when it doesn’t work — CHIP enrollment is still around 60-70% of projected eligible children in many states, and as for auto insurance . . . cops will tell you anywhere in Ohio, and my inference is that this is a generally national phenomenon: 1 in 3 cars on the road have either a lapsed registration, no insurance, expired or cancelled driver’s license, or an outstanding warrant for something. Which works out, given that traffic stops are not “randomly” distributed, that 2 of 3 traffic stops, or more like 4 out of 5, will turn up a legal problem.

    In my day job, we find that outstanding warrants, liens, and court orders, especially around child support enforcement issues, keeps many families from accessing help that they and their children qualify for, for fear of triggering the attention of the legal system. It’s like the challenge with illegal aliens and their children when benefits are available, but the family won’t fill out forms even with a promise that immigration will not be handed the info.

    It’s a complication of how to deliver health care that we mull over often, and a factor that keeps the “one day free clinic” approach popular even as we often utterly fail to get people enrolled for Medicaid/CHIP while they wait in line — there are so many families that simply want/need to stay below the radar. That’s what i hear from our local ER docs about follow-up care from the Saturday late night road burn cases, or parents with kids coming in Sunday afternoon. Is there a better way to deliver community-wide health care?

    And if someone finds a comprehensive link that’s somewhat less than 1017 pages to discuss the French system, i’d appreciate it. What scraps i’ve read are interesting, but i just don’t quite get the picture of how they’ve figured out a both/and solution that allows some market influence to shape consumer decisions, but protects vulnerable populations.

  57. ROgirl said on August 25, 2009 at 9:22 am

    TR Reid has written a book comparing the health care systems of other countries with ours. It’s just coming out this week, so it will be interesting to see if it has any influence on the debate. Here’s an article on the subject.

    http://www.washingtonpost.com/wp-dyn/content/article/2009/08/21/AR2009082101778_pf.html

    He was also on Fresh Air yesterday and you can go there for the interview.

  58. velvet goldmine said on August 25, 2009 at 11:20 am

    Julie, Thank you for the hopeful anecdote! You’re right that it probably isn’t an insurmountable issue; in fact, my mother has even offered to help with some of the out-of-pocket. I just have this weird fear that it will somehow turn out to be an injury that does require surgery, and that it will screw up my chances of getting insurance down the road. But that’s silly, and your success story will definitely spur me to make that first appointment, which I will probably need to get going with the PT.

  59. Rana said on August 25, 2009 at 1:12 pm

    Jeff, I prefer single payer, for many of the reasons you lay out. But with the insurance companies sticking their fingers in the pie, we’ll be lucky if we get a public option with mandates and subsidies.

    I cannot say how disgusted this makes me. Greatest country in the world, my ass.

  60. caliban said on August 26, 2009 at 6:11 am

    Christian lawmakers support insurance companies that spend more on disqualifying people that have paid premiums for years than actually taking care. That is the system we have, and it appears to put old folks away at least two or three years erlier than the UK or Canada.

    Health care is better everywhere else. What’s the problem. The ultimate capitalist sharks that have fed on everybody that paid premiums and then suddenly needed care and they just bailed on them? And major league numbers negotiating for perscriptions might cut into the drug company advertising budget?

    Drug companies don’t spend money on research, they try to convince idiots to influence doctors. Drug research? That’s virtually all athe government, but since you all want hands off My Medicare, we’re so gd dumb we think Pfizer cres.