Meet The Firewall [David’s blog on saturday morning smack-dab]

I’ve decided that I am stuck in the past. I used to call my doctor when I needed immediate doctoring, when I had the flu or, like this week, a suspicious bug bite that slowly started to take over my body. I admit to being a slow-study. It’s taken more than a few experiences to learn that when I need some medical attention from my “primary care physician” I will always – always – be met with a firewall called “the next available appointment”. Sometime in 2027.

A relevant side note: please keep in mind Master Marsh’s wise insight: “Customer service is a firewall against serving the customer.” I’ve discovered the same might be said of doctoring in these un-United States. My relationship with my primary care physician is, in fact, a firewall against primary care.

I’ve finally learned my lesson. As a first step, from this day forward, I will always go to urgent care. Or, I will join the legion of people clogging the arteries of the ER for non-emergency but very costly services. But I will never-ever call my doctor. I’ve learned at last that PCP stands for Periodic Care Physician.

In truth, I feel badly for my PCP. During my last visit for an annual physical he raced in and out with his rolling computer cart to maximize the seven minutes he was allowed to spend with me before he rolled on to his next seven minute patient encounter. He was moving so fast that he “mis-coded” my annual physical as a “welcome visit” so, apparently, in his mind, we sipped scotch and took a tour of the property. Sad. He barely had time to listen to my heart and has no time to listen to his own heart. I’m certain he went to medical school to help people but has found himself doing factory work and we-the-patients are his assembly-line-widgets.

I doubt that this was the career he imagined. It’s an unimaginable system that is designed for excessive billing and, therefore, is fantastically profitable – our healthcare system costs seven times more than any other developed nation – but has little or nothing to do with health or with care.

(Hey. Wait a minute! A spider bite was how Spiderman got started! I’ll keep you posted if I find that I am suddenly able to scale walls or swing through the city from self-generated webbing).

read Kerri’s blogpost about HEALTHCARE

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Feed The Mantra [on KS Friday]

As part of the 2020 census, Kerri and I were randomly selected to participate in a healthcare questionnaire. On first glance this might seem worse than a spoon full of castor oil but we were excited because the system of healthcare in America has been ruinous to us. There isn’t a single life decision that we make that doesn’t run through the fractious draconian system we mistake for health care [note: the good people who populate the system, the nurses and doctors and technicians are remarkable. My barb is meant for the money machine that intercepts our capacity to create a system that places the health of the citizens as central to the mission].

We spent an hour on the phone with a lovely woman who asked us multiple choice questions that were carefully written to avoid any real data. When she asked us if, over the last 12 months, we’d experienced anxiety, hopelessness, or depression, we burst out laughing. She laughed, too. “Was our level of anxiety high, somewhat high, moderate, little, or very little?” We answered with more laughter and she said, “Well, I have to ask!”

I told her the story of taking Kerri to the hospital the night she broke her wrists. Wrapped up like a mummy, in great pain, we sat for several minutes in the parking lot staring at two doors. The first led to the emergency room and would, no doubt, also lead to bankruptcy. The second door led to urgent care and perhaps an inability to care for a pianist with two broken wrists. We debated our choices for several long minutes. Keep in mind, we have healthcare. It is more expensive than all of the rest of our bills combined. And, we are afraid to use it.

“Have you avoided treatment or refused treatment in the anytime in the last 12 months because of cost?”

“Yes.”

We told the lovely woman conducting the questionnaire how much our premiums actually cost and she gasped. Literally. “I had no idea,” she muttered. Her job provides healthcare.

We access our coverage through the misnomer, Affordable Care Act. It provides a supplement so we can actually “afford” our coverage but access also comes with a cliff. It’s constructed like a cage. It’s an all or nothing abyss that prevents us from earning a living. We cannot earn enough to pay our bills because we’d have to jump a mighty-premium-reimbursal-crevasse to make enough money to survive the cliff. Catch-22. It’s why I stopped showing or selling my paintings; a single extra dollar could have pushed us over. Our get-out-of-jail-free-card? A job with healthcare.

For a moment, the lovely woman winced and was silent on the other end of the phone. “There’s no space to put this information,” she said. “I’ll put it in the notes at the end,” she said to herself. We knew, all three of us, that no one will ever read the notes.

We left the questionnaire disappointed but affirmed in our belief that nothing will change anytime soon. Our fatal blind spot in these perhaps-soon-to-be-united-states is that we think everything needs to run like a business. It’s why our schools fail. It is why our prisons are over populated. Market forces come with levers that work well if you are selling electronics but are debilitating if your are trying to educate children or provide accessible healthcare to a citizenry. I’ve seen many, many arts organizations and other not-for-profits enter a death spiral when a “well-meaning” board member insists that the organization run like a business. Apples cannot be oranges.

We feed each other a not-insignificant mantra these days. This is where we are. Let’s not miss this day. Rise above the circumstance. Each day, new. Let’s live, fully live, right here, Right Now.

RIGHT NOW and all of Kerri’s albums are available on iTunes

read Kerri’s blog post on EACH NEW DAY

each new day/right now ©️ 2010 kerri sherwood

Know The Matter [on Flawed Wednesday]

healthcare.gov copy

I’ve had this conversation twice in my life. The first time I was working in The Netherlands. The second time I was working in Canada. The conversation, both times, started with exactly the same question:  What’s the matter with you Americans?

It is an irrefutable fact: we (Americans) pay more than 7 times what any other nation on earth pays for healthcare and we provide poorer coverage for less people. Our life expectancy is shorter. We are an obese nation. Our infant and maternal mortality rate is higher than any other developed nation.

What’s the matter with (us) Americans?

Here’s another irrefutable fact: the top 1% of households owns more wealth than the bottom 90% combined. The gap is, in fact, growing.

We are being force-fed the fear of socialism* but, if you dare, take off the blinders, plug your ears to the noise of heated misdirection, and look at the data. It’s clear that our fear should be of the oligarchy.

What’s the matter with (us) Americans? We are too easily led, susceptible to diversion by division, and extraordinarily fact-averse. We are too lazy to question, research or otherwise investigate the easy tribal narratives of red or blue. We are (to borrow a great book title) a confederacy of dunces.

The stresses of “healthcare” are making most of us sick while making a very, very few of us as rich as Croesus. That is another irrefutable fact and is the crux of what is the matter with (us) Americans.

 

read Kerri’s blog post about HEALTHCARE.GOV

 

*try this experiment (I have and it is eye opening): To everyone who screams in fear the word “socialism,” ask them to define the word “socialism.” You will find, as I do, the screamers can’t define it. They don’t really know what they are screaming about. They (we) also are inordinately incapable of defining “oligarchy.” That is (sadly) why I’ve provided links. It is also an alternate answer to the question, “What is the matter with you Americans?” I decided in the final moment to exclude a link to the words “representative democracy.” Given the irrefutable but too often denied facts, it begs a whole other set of questions.

 

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