ObamaCare and the Return to Marcus Welby

Obama's urgent need to confiscate tax money to cover everybody's health care is an indicator of how far medicine has come since I was a kid.  His pressing insistence has a basis in the same technology that brings you this blog, and the apps on your iphone, and your music and photos and games and Kindle--and there's no way we'll ever retreat.

Way back in the far reaches of my memory was chicken pox.  It was a disease your mom made sure you got, by sending you to play with some spotted friend, because you needed to "get it over with" lest it strike with greater force once you became an adult.  Kids don't get chicken pox any more. They get MMRV shots as babies, ending the social delight of intentionally exposing youngsters to "childhood diseases" that are no more.

But when my siblings and I were in the midst of "getting it over with," the pediatrician, as part of his normal duties, showed up at our front door.  I vividly remember him--a stranger to me, really--coming into the bedroom I shared with my similarly-stricken sister, his leather black "doctor's bag" in hand; his cold stethoscope on my chest.  They used to call those visits "house calls."  They didn't cost extra.

In those days, families paid for just about everything outright.  You got a bill from the doctor; if you couldn't pay it all at once, you worked out a payment plan. Yes, there was insurance, but it was private (Blue Cross), not very expensive, usually only for really catastrophic situations, and most people didn't have it.  Certainly no employers paid for it.

Until the 60s, when governments and unions used coverage for bargaining and as perks for employees.

Then, in 1965, President Lyndon Johnson, in a fit of liberal largesse, sought to provide retirees with government-sponsored health coverage.  At that time, most people retired at age 65 and looked forward to rapid decline, surviving at most another decade, as US life expectancy was only 70 years.  Medical care was just starting to get technical; pharmaceuticals were becoming more sophisticated and proprietary.

Without universal retirement plans, a new class of oldsters who weren't being taken care of by newly mobile children got attention in Johnson's "War on Poverty" after exposes about their subsisting on dog food.  Medicare filled in where Social Security left off, followed by Medicaid, the national program for non-elderly poor. But the key there is that it's not federally-managed--each state controls its administration locally. 

Really, it's only been in the last 20 years that HMOs and employer-subsidized health plans became de rigueur, severing all direct connections to local doctors and inserting middlemen at faraway desks, insulated from customers by powerless phone personnel.  Ask a kid what a doctor's bag looks like--he'll shrug.

Do we customers like dealing with huge corporations who determine our premiums, our co-pays, our deductibles?  Do health care providers like that their fees are negotiated and set by the same corporations?  Ever get an "EOB" (explanation of benefits) from a health insurance company that lists a doctor's charge, and then the "adjustment" he makes because the insurance company decided his fee was more than they've decided to pay?  What is this game?

It's the stuff of consumer backlash.  Because if taxpayers know one thing, it's that adding layer upon layer of government bureaucracy onto a system that's already rife enough with regulations, strategies and middlemen isn't going to streamline anything. Instead, it will complicate and worse, cost much more.

By the way, I'm incredulous that thousands of American citizens die each year due to inability to afford health insurance.  Emergency rooms do not turn away indigents.  Medicare, Medicaid and local governmental programs do exist. And private charitable institutions do a tireless job. College and university students have campus resources. And 1,200 free clinics, staffed by generous physicians, exist in every metropolitan area.

Can we ever go back to the friendly Dr. Welby of the olden days? Of course not. We now demand medical science provide magic pills and room-size equipment that hardly fits in the traditional physician's bag.  We seek specialists for second opinions, and form our own analyses by scouring the internet, sometimes spurring expensive lawsuits, served by eager lawyers.  Health care is increasingly complicated, and we now expect to live a lot longer than before. Into our 90's, actually. 

The US spends 16% of its GDP on health care; more than any other modern country.  It's not going to drop--either with feds controlling potential profit or with the status quo, because free enterprise is already so tamped down by government regulations and laws that shape the structure of the insurance industry. What's the answer? I'm not in a position to speculate, but getting back to catastrophic insurance coverage, with individual management of relationships with doctors would be much better than the interminable phone waits and impersonal rulings on payments that we all now face--which would be much, much worse controlled by the biggest bureaucracy of all, the federal government.

Groundhog Day Redeux

It's overcast here. Punxsutawney Phil would not have seen his shadow today, and we would have delighted in the prospect of an early spring.  Yesterday, however, we got some sun, and apparently, so did the groundhog in Pennsylvania, portending more chill.

The 1993 Bill Murray film "Groundhog Day" is one of my all-time faves, because  of its novelty and its message.  Murray plays Phil Collins, a narcissistic TV announcer sent with his producer Rita (Andie MacDowell) to cover the official result of the animal's appearance. Stuck in town due to a blizzard, Phil finds himself in a time loop, repeating the same day over and over until he gets it right.  Even suicide attempts fail as he again awakens in his hotel bed to the strains of Cher singing "I Got You, Babe" on the clock-radio.

During the course of the film, Phil transforms from self-centered to altruistic, from viewing time as his own to seeing his place on earth filled with possibilities.  In the most miserable of weather, in the most mundane of locations, Phil realizes that the six weeks of winter the rodent portended was his means of emerging from hibernation into the sunshine of experience.

I often wish I could repeat days and get them right.  When, like today, a gray sheet of damp, dismal clouds encloses my view, I have to force myself toward gratitude and accomplishment.  Sunny days, on the other hand, energize and uplift me, pulling me outside in exuberance.

So I wasn't thrilled when I heard that we're in for a typical winter, six more weeks of dreary chill.  Time for some attitude revision on my part.  It may be Groundhog Day, but it's also a new opportunity, if I just step out of my narcissistic stupor.

In Denial of our 25th Anniversary

There are plenty of articles out there about Boomers in denial.  OK, it's tough for me to admit I've been married a quarter-century.  Supposedly after 25 years, you're eligible for your quarter-life-crisis.  That's after 25 years of living.

    I look at the people who are my children, and feel like they ought to be my peers; their friends and I should be jumping in the car to go shopping and to a movie, but what is this? They don't want me along.  Somehow against my will I landed on the wrong side of the generation gap.

     As January 27, our anniversary, approached, I told my husband to just ignore it. "It's an important milestone," he protested. "No," I insisted, "every day is our celebration. We don't need a big deal."  It's such chutzpah to throw yourself a party, like everyone should fete you just for staying together.
     So my hubby arrived home from his business trip this week to find our house decorated (partly by a dearest friend who snuck in on our anniversary day and strung streamers and balloons while I was at the gym, wildly embellished by me).  I'd wrapped up my romantic gifts of two shirts and four pair of pajamas.  (Now, he'd been asking for pajamas.  I really meant it when I said I wanted to minimize the occasion.)

     Our close friends asked us out to a dinner celebration; I demurred, saying my hubby had mentioned a private escape, but when Hubby suggested we accept, I caved.  Yesterday it dawned on me: Surprise party.
     Oh yes. All the pieces started falling into place.  And sure enough, as we neared the restaurant--Indian food our hosting friends despise--I saw far too many familiar cars.  As I walked in to the chorus of "Surprise!" and the smiles of all our friends, I felt both honored and exposed, because proud as I am of our 25 years married, the idea of being more than 25 years old myself seems impossible.
    Misgivings dissipated amidst hugs and good wishes from friends I love, all of whom share a precious corner of my life. Their children have grown along with mine; living in proximity in our Jewish neighborhood, they have spent Shabbat afternoons in our home and shared graduations and birthdays and the dreary weather and snow days and heat spells.  That so many years could have mounted is mystifying, but the depth of ecstacy in sharing them is undeniable.
   We Boomers may never grow old; we may never admit our physical limits or open AARP solicitations, but we'll claim the friendships and recollections that sit like snapshot signposts of our satisfactions.  As my rabbi frequently reminds us, there's no word in Hebrew for retirement; to admit to maturity could slow us down as we collect marathon t-shirts, earn added diplomas and take on major projects.
   Thank you to all our friends for an unforgettable 25th Anniversary; to see my husband beaming with childlike glee at pulling off his surprise was almost as priceless as your presence, the context of our very blessed lives.

A 'Wrong Turn' to Ginkgo Petrified Forest...and adventure

Yesterday, while on an excursion in Central Washington state, we relied on our car GPS, and it put us on the I-90 freeway going the wrong direction. This wouldn't be a big deal, except the fact that the next exit was 25 miles away over desert scrubland.

The six-lane freeway was separated by a parched dirt median that was generally about three hundred feet wide, and often at differing elevations, but every so often when the two opposing directions converged, there'd be an asphalt connector with a prominent "No U Turn" sign.  My husband missed a couple of them, as they were curved and unmarked, but when we neared a visible one, he wanted to veer. "No! No!" I screamed, eyeballing the ominous sign and the fact he'd have to abruptly swerve across two lanes to make it.

We passed the turn but a couple miles further, my husband's grumbling at our compounding our detour erupted into out-and-out annoyance that we faced miles more of this G-d-forsaken desert. Why didn't I let him turn? Nobody would have stopped us.  My protests that it was dangerous were out-groused by his perturbed accusations.  Then he missed one, then two of the turnarounds himself.

By the time we found the first exit, we were at Vantage, Washington, on the Columbia River, which stretched wide and long between the brown mound-like hills.  A sign caught our eyes:  "Ginkgo Petrified Forest," with an arrow.  Ginkgo? There's a petrified forest of Ginkgo here?  Who could resist?

An interpretive center was closed for the winter, so we walked around reading all the informative placards on the scenic bluff overlooking the rolling Columbia.  Petrified logs were placed everywhere, just lying out. On the way to our car we were captivated by a sign inviting us to see the Wanapum Indian petroglyphs...right out there, a few feet away, exposed to the elements--primitive drawings that are 200-10,000 years old.  Scratched onto black basalt were representations of animals, people, arcs and geometric designs that had been moved about a mile to their perch overlooking the Columbia when the Wanapum Dam submerged their original location.

But most fun was visiting the Gingko Gem Shop, marked by petrified logs and large colorful dinosaurs, where the proprietor told us that despite the plethora of petrified trees in the area, just four petrified ginkgo trees had been found--and they comprise a mystery. Apparently ginkgos were wiped out 50 million years ago when glaciers covered North America. Only one species, Ginkgo Biloba, the same tree that provides the medicinal supplements touted to increase circulation and therefore brain acuity, originally from China, lives today, and only under cultivation.  The University of Washington says it's the oldest tree anywhere that has continually survived--thanks to Chinese monks who carefully fertilized and grew them over millenia, despite the messy and stinky fruit of the female of the species. 

How these four ginkgo trees, in their little cluster, managed to remain as the only petrified souvenirs of their North American existence, continues to baffle geologists.

While at the Ginkgo Gem Shop, we purchased our own little polished piece of petrified wood, and I took a photo of another bizarre relic on display there: an Apatosaurus femur. Yes, a big thigh bone, just sort of resting there on a wall.

You never know the wonders you can encounter, serendipitously.

My husband's irritation assuaged, we headed back to the freeway, stopping for espresso at a delightful, eccentrically-decorated little restaurant called Blustery's.  The owner, Greg, turned out to be a fan of my fave radio host, and introduced us to the only other person in the restaurant, his friend who happened to be a pastor--who got the calling to pray that Fave Host should be divinely guided in his broadcasts.  Thus fortified, we headed back on the freeway toward Seattle, most of the way through a snowstorm so dense and windy the splattery flakes seemed to fly horizontally into our windshield.

Who's to say we took a wrong turn yesterday?  It wouldn't be me.

Bye-Bye Air America

RIP, Air America. "The company, which was founded in 2004, never found a substantial audience or sound financial footing," explained an article in the New York Times. "It filed for bankruptcy protection in 2006, but managed to stay on the air at that time. The network churned through several owners and several attempted reinventions, with little to show for it."

Why is it that the one liberal--pardon me, that word has been replaced--progressive attempt at talk radio syndication struggled for its six years, yet even after the economic meltdown depressed advertising, several conservative radio networks continue to thrive?  Air America, in its final hurrah, had at most 100 outlets nationally, while in many markets two or more conservative talk stations coexist and profit, side-by-side.  Rush Limbaugh, whose program began in 1988, has about 590 stations according to Wikipedia.

Why is it that "progressive" talk couldn't muster support, while conservative talkers command loyalty?  My fave host consistently ranks at or near the top of our local ratings, even when measured by the new electronic "people meters" that replaced the old Arbitron listener logs.  Why should right-leaning talk boast dozens of radio stars and the only left-leaning network collapse within just a few years?

I think it's because the vast majority of print and television media already offer liberals, uh, progressives, their perspective.  You don't need to tune in to radio when you can hear pro big-government TV reporters on evening newscasts, and read liberal editorials in the New York Times, Los Angeles Times and Washington Post.  The Hollywood establishment was the source of the term "politically correct," because it's almost laughable how uniformly America-critical actors, producers and scripters are.  Eighteen months ago, if you said the words "George Bush" in certain LA restaurants, you'd hear a simultaneous hiss from everywhere in the room.  These are the moviemakers, the TV network brass, the faces you see in tabloids, and they're so surrounded by like-minded friends that they assume you, too--out there in TVland and theater audiences and reading your paper in Starbucks--you, too, must agree.

The only escape has been talk radio.

So, there's no need for "progressive" Air America because television airwaves and internet cables and movie theatres near you are already ringing with its message.  "Avatar" is going to beat "Titanic" as the most profitable film ever, for its stunning effects and action-packed plot, but what it teaches is that the Na'vi, living in harmony with nature, are superior to the greedy villainy of capitalism and technology. Going to see the film may be a great experience (I wouldn't know; I can't take violence so will never view it) but inserted in the enjoyment is a "progressive" message.  That's fine, but few movies offer the other side.  That's why we need talk radio.

My fave talk host relishes debate and discussion; he enjoys persuading disagreeing callers of his viewpoint, using logic and patience.  Other talk hosts blare and rant, sometimes ridiculously, but the medium, with the immediacy of callers' questions and responses, is always engaging.

That Air America sought to add its voice to the fray was never a threat, never a problem for conservative talkers; in a way it's a pity it failed.  But it failed not because its perspective was unwanted or unwelcome--in our great land open discussion is celebrated.  No, Air America flopped because it was redundant and unnecessary.  The beauty of capitalism is that entrepreneurs profit when they provide something unique that other people want to pay for; Air America just wasn't fresh enough, so it spoiled.

Propostion 8 Trial: Loving the Sparkliest Person Vs. The Needs of Society

The US District Court trial in San Francisco on the constitutionality of California's Proposition 8 is rife with emotion. Coverage in the New York Times Tuesday described Kristin Perry, co-plaintiff, answering her lawyer's query about how she fell in love with her partner, Sandra Steir: "I remember thinking that she was the sparkliest person I'd ever met."

While I hope Ms. Perry and Ms. Steir have a happy life together, I do not believe that those who find another to be the sparkliest--or the most wonderful, or the most attractive, or the most brilliant person ever--should necessarily qualify for state sanction in marriage.

Theodore B. Olson, attorney for the plaintiffs, said he will show that gays and lesbians suffer "grievous harm" because they lack state recognition as "married." It appears that a goal will be to show that for those deeply committed and in love, having all the legal rights of marriage (which same-sex couples are guaranteed by law in California) but not its moniker, is "grievously harmful."

I know teenagers smitten by admiration for rock stars who crave them so much they faint.  Though I was a mere child at the time, I vividly remember seeing video of Beatles audiences where women regularly swooned, screamed, cried hysterically, and fell unconscious with adoration.  One might assume these young women felt John, Paul, George and Ringo were far more than "sparkly."  Depth of feeling for another person may create a relationship, but it does not constitute or necessitate marriage.

In fact, last June, Gov. Mark Sanford, who waxed poetic in a raft of emails to his "soul mate" Maria Belen Chapur that spelled the end of his presidential hopes and probably his political career, was also deeply in love.  Given his wife Jenny's patient response, he should have been able to marry Maria as well. After all, he didn't want to end his 20-year marriage, as he announced when Jenny finally filed for divorce--instead he called the outcome "tragic" and "not the course [I] would choose."  With a deep desire to be with the women he loved, forbidden by law to be married to both simultaneously, Gov. Sanford--and his children--must've suffered "grievous harm."

I do think it's true that California marriage law discriminates against same-sex couples.  Couples where both partners are the same gender are treated differently from couples where the partners are of opposite sexes.  That's called "discrimination based on sex."  Which for many purposes is perfectly legal, and which advocates of gay marriage do not seek to change.  For example, women are not required to register for the draft, and if there were one, women would not be required to serve.  Public restrooms may be segregated by sex.  Male and female convicts go to facilities separated by gender.  And California marriage laws always assumed--and now specify--a bride and a groom.

Though zealous gay-marriage advocates outside the District Court trial brandish signs insisting on "the freedom to marry," at this point, none of them are willing to insist on complete freedom, though they may seek it later on.  They don't plead for polygamy or polyandry; they don't march for incest; they don't claim that children, or any collection of in-love, committed people should gain state-approval as a "marriage."  In other words, they seem to want all of the traditional restrictions on marriage to stand--except the most basic one, the combination of male and female.

And as for "the freedom to marry," well, anyone is free to perform a non-state-recognized wedding.  Pardon my ignorance, but isn't it said that Catholic nuns are "married to the Church"?  What about the hippie communes, some of which continue today, where all participants share everything, including their bodies, in a love-infused commitment?  Circuit court plaintiff Perry proposed marriage to her partner in 1993, with the result that "She looked really happy" before she "looked really confused." They got married unofficially. Are happiness and confusion the makings of "grievously harmed"?

Actually, though marriage laws may assume or specify the genders of participants, neither gender is treated differently, or suffers any discrimination.  Any individual is able to legally marry one of the opposite sex.  That includes everyone, and excludes or discriminates against no one.

The issue here is that some people want legal recognition for marriage to someone from a legally prohibited group. Prohibited groups include children, those already married, people who are mentally incompetent, men and women who are close relatives, and those of one's same gender. As I mentioned before, gay marriage advocates want to remove one of the restrictions yet leave all the rest--does that make sense?

I do think that for many on the left, the underlying aim is to dissolve the institution of marriage altogether. A great 2006 article by Stanley Kurtz in National Review Online describes an underlying agenda, published in a document called "Beyond Same-Sex Marriage" and supported by respected people like Gloria Steinem and Rabbi Michael Lerner, to be approached one step at a time.  Gay marriage is the first step.  Insisting on equal honor and government support for any and all chosen relationships is the ultimate goal.  Kurtz doesn't say this, but if you reduce the argument further, the desired outcome is for honor and government support not for permanent commitments, but for any and all types of sexuality.

Which is what it comes down to.  Marriage has been the societally-preferred setting for the type of sexuality that produces those societies.  It is not about commitment to "the one you love," but to stable families.  The guys carrying the signs in front of the District Court who want "the freedom to marry" have it.  But society's future depends on raising a healthy generation of children in the environment most conducive to their flourishing. That's where the state has a stake in traditional marriage.

The people of California understood this, adding to their constitution in Proposition 8 just one sentence: "Only marriage between a man and a woman is valid or recognized in California."  I hope the US District Court gets it, too.

Enslaved Jews Didn't Build Pyramids--And Jews Aren't Pirates, Either

"Proof" that no captive Jews--indeed that no slaves at all--built the Egyptian pyramids has headlined newspapers around the world by now.  An Associated Press story by Katarina Kratovac that's been reprinted everywhere verbatim says the discovery of 9-foot shafts, each holding the preserved remains of a dozen skeletons near the Great Pyramids of Giza on the outskirts of Cairo bury the "myth" that slaves constructed the last remaining Wonder of the World.

The article says Hollywood movies perpetrated "an erroneous claim by former Israeli Prime Minister Menachem Begin, on a visit to Egypt in 1977, that Jews built the pyramids."  Support for the no-slaves stance comes from Egypt's chief archeologist Zahi Hawass, and Hebrew University archeologist Amihai Mazar, who says "Jews didn't exist" when the pyramids were constructed. Despite Greek historian Herodotus' description, current experts insist paid workers created them.

In checking this out, I came across a Jerusalem Post story in which Farouk Hosny, Egypt Minister of Culture, was quoted as telling the Associated Foreign Press, "Israeli allegations that they built the Pyramids abound, and we must face up to this even if it triggers a crisis with Israel! This is piracy! Our history and our civilization must be respected but the Israelis want to take over everything! We must counterattack with full strength because this is how they took Palestine. They think Palestine belongs to them and now they are doing on saying the same with the Pyramids."  My, my. Doesn't sound purely academic to me.

While it's true that many people do think Jews built the pyramids, the Torah (in our portion of this last week, Shmot, aka Exodus) and the Passover Hagada say only that Jews were enslaved and forced to build the storage-cities of Pitom and Ramses, which archeologists agree likely coincides with their residence there.

  It's certainly cinematic to show Jews working on the pyramids, but Jews haven't been "pirating" credit for them from Egyptians.

Still, the articles I've seen in news media (nearly all of which are the same AP story) don't explain how the newly uncovered skeletons show that workers were paid and not slaves (even though they weren't Jews). Proximity of the burial shafts, and the presence of beer and food there, say Egyptologists, are the key. But studies on the skeletons apparently reveal signs of back-breaking work and early demise. I'd really like to learn more, and explore why Egyptian archeologists come across so emotionally about what should be an objective, careful and strictly scientific analysis.