Responses to subjects brought up by this blog are welcome. I can be contacted by e-mailing me from my website.
Subjects this month: Slowing down, Global ebook award for Doggie Biscuit!, Book reviews, Progress Report, I wonder about this, Series: State of America: Our crazy medical care system, Excerpt from Alien Seeds.
I don’t know if anyone has noticed but my writing has abruptly slowed down. I haven’t finished the third Apertures book in the time frame I normally would and also haven’t progressed on some other projects as quickly as normally. The reason is that Pain from the neuropathy of my feet and lower legs was distracting me and causing me not to sleep well. It had gotten so bad that even Oxycontin didn’t help very much. I just began taking a medicine for neuropathy of the extremities and it has really helped. The pain has all but disappeared. The downside is that the medicine makes me so dizzy and lethargic that I’m still not getting much done. Betty is having to drive for me because I don’t trust my judgment. These side effects wear off after a few weeks for most people. I sure hope I’m not one of the 6% or 7% where it doesn’t!!
One week later: The side effects are still around, plus others have popped up periotically: confusion, blurred vision and rapid heartbeat. I’m going to give it another couple of weeks and see if the side effects will wear off because otherwise it works so well. I’m sleeping good for the first time in a while with no neuropathy pain at all.
Global Ebook Award for Doggie Biscuit!
My humorous book, Doggie Biscuit! was a surprise finalist for the Global ebook awards. (It is also in print, by the way). Biscuit was our Dachshund, a mix of the full size and miniature dachshunds and a full member of the family. In fact, he pretty well ran the family for the seven years of his all too short life and Betty and I are both pleased at the number of people who have had good things to say about this book. A lot of people had good things to say about him when he was out and about, too. The ladies at the bank all knew him and made sure he got extra doggie biscuits when we appeared. When we went through the drive-in window of the bank he was a study in still motion as he hung his head out the window, every bit of his attention fixed on the air tube opening of the containers. When he heard the return begin he practically crawled up the return vent waiting on his biscuits and to heck with the money that went with it. He knew the ladies wouldn’t forget him, even at the drive-in window. He had an extensive vocabulary and from the time he was a puppy he spent a lot of his life sitting up on his back legs and butt, getting as high off the ground as possible so he could participate in events and use his front paws to gesture with like a regular people. He held rawhides and ice cream cones in his paws with equal dexterity. He…well, read the book yourself. Give it as a present. The recipients will thank you!
The soul-searing best seller Unbroken by Laura Hillenbrand (also the author of Seabiscuit) tells the story of an Olympic runner and his place in WWII as a crew member of a B-24 in the Pacific. Their plane is shot down and he and two others survive the crash into the ocean. They were stranded on a raft at sea for 45 days, existing on very little, water they could catch from showers and seabirds or fish they could catch with what was on the raft. When they are finally rescued by the Japanese, they are imprisoned on Islands and then sent to Japan as slave laborers. They and other prisoners were abused, starved, beaten and worked virtually to death. Hillenbrand’s account of prison life and the PTSD that followed is enough to sear your soul. Betty and I were both mentally and emotionally exhausted by the time we finished the book. I have read other books of POWs but this one really got to me. Most of us can’t imagine living through something like what happened to those men and many of them didn’t. What is amazing is that so many survived. I urge every one who is concerned about our military to read this book then thank the stars that we have men and now women like those defending our country.
Von Neuman’s War by John Ringo and Travis S. Taylor is a plausible novel of what might happen if a swarm of Von Neuman’s self-replicating robots from another world find their way to earth. These particular machines eat metal in order to replicate and have no other purpose but to use up all the available metal in a solar system to make giant structures then move on to another star with planets. First astronomer’s notice that Mars has changed its albedo, then other of the planets. A satellite sent to Mars shows vast structures created by something. Then the moon changes and the machines are found. Next comes earth and a battle to survive. This book is really interesting for the way the characters use science to battle the machines. It also describes the inner working of the army and the pentagon, but I really liked the way they used a paranoid scientist who has been belittled by his colleagues but is now a key to possibly winning the battle for earth. A really good read.
I read three of Sheldon Siegal’s trial lawyer books again, Special Circumstances, Incriminating Evidence and Criminal Intent. Siegal writes in a matter-of-fact style that I like and in first person, which isn’t always best but he makes it work and work well. Without going into the plot of these books I’d just like to say that he makes it difficult for anyone to guess whodunnit because he keeps so many subplots going, some related to the case in the book, some not--but you don’t know which. And in either instance in these three fine books there are surprise endings that most readers will never see coming. I sure didn’t.
I re-read one of my own books, Galactic Frontiers. It’s a coming of age science fiction novel, and boy, does this kid come of age quick! Aliens are also in the picture and it becomes funny because the settlers of the far frontiers have brought some enhanced dogs--which turn out to be absolutely ga-ga over the aliens! It gets kind of funny in the end stages even as the situation becomes more serious. I really didn’t remember writing the book in this vein and got a lot of chuckles from reading it. It’s also much better than I remember! Recommended.
Resolved by Robert K. Tannenbaum is a Butch Karp novel and Tannenbaum does his usual good job of writing by bringing back an old thoroughly despicable character who turns out not to be quite as smart as he thought he was. Karp’s wife continues to deteriorate but no final solution is evident in this book so look for more of Marlene in the future.
If women and minorities, especially blacks, think there hasn’t been much progress since the dark ages they should read The Axis of Time trilogy by John Birmingham. A United Nations naval task force is accidentally propelled backward in time and ends up smack in the middle of the United States Carrier Force that is just about to begin fighting the Battle of Midway, which was the turning point of WWII in the Pacific. They wind up shooting at each other at first because neither one knows what has happened. By the time the mixup is resolved most of the ships from WWII have been obliterated but a number of the ships from 2021 have also been sunk. Now the two forces have to band together to fight WWII, but the contrast in lifestyles is so extreme that the warriors from the future, which includes women, Blacks, Hispanics, Gays along with their liberated attitudes and the ones from 1942 have real difficulties understanding each other and getting on with the war. No, they have tremendous difficulties understanding each other and working together. This trilogy is very well written. It is military fiction but just reading and seeing the contrast in attitudes 80 years apart makes it worthwhile whether you like the military genre or not. Birmingham presents the major players from the WWII era as well as the fictional characters extremely well. Highly recommended!
One of my previous books, Mogollon Rim: Seeds of Destruction has been reissued with a new cover and new title: Alien Seeds. It is available in ebook editions and should be in print by the time you read this.
The second book of the Apertures Trilogy is now out in the ebook version and if not in print by the time you read this it soon will be. The title is Allies and Enemies Apertures Two. Both are stand alone novels by the way, but they’re better read in sequence. In the second novel, America is gradually producing Apes (aperture formers), but not enough to counter the numbers the Pankan empire is using. Only twins Jan and Jani’s super talents have been keeping the Pankans from overrunning our alternity. In an effort to find out how they are producing so many Apes, Jan undertakes a special mission that lands him and his team in a world of trouble. Wounded so badly that he cannot create apertures to get them back to our Earth, surrounded and with the enemy closing in, he and his team are also betrayed by one of their new Apes, making the situation more dire than ever just as full scale war breaks out. I’m having a great time writing this trilogy and am now 30,000 words into the final novel.
Anyone who has read Toppers, and laughed themselves silly will be pleased to know that at last the other half of this insane dialog between Darrell Bain and Will Stafford has at last been released as an ebook under the title MoreToppers, available wherever ebooks are sold. I laughed myself silly again while reading it. At a later date both Toppers and More Toppers will be released in Print and ebook as a single book under the title The Complete Toppers.
I wonder about this
There’s something I wonder about. Anyone who has read much of Bainstorming knows I don’t think much of those people in Washington, of either party. They spend money and pass programs that are designed to keep their party in power and/or keep them in office. All of those congress critters, the President and the thousands of lobbyists all have to know that what they are doing is hurting the country. And most of them have spouses or partners. I often wonder how the significant others of those Washington critters can stand to live with them, knowing what they are doing. Are they blind? Or do they not pay attention to what’s going on in Washington? I don’t understand and I wonder why those spouses and partners don’t. Do you ever wonder about this? I’ve never read anything about them caring, unless the Washington critter gets caught in the wrong bed, and then they’re still not caring about what’s being done to the country. They just say they support or don’t support the person in trouble. BTY, you can multiply what’s going on in Washington by a factor of 50 for the same thing happening in each of these United States. Those significant others don’t seem to care when the people they live with put the states so far in debt some of them are worse off than the rest of the country.
Oh yeah. I live in Texas and read about Rick Perry every day, or more often don’t read the things written about him because it‘s been gone over too many times already. And Texas isn’t as fiscally responsible as the newspapers, TV and on line news say it is because a lot of it is hidden. For instance, Texas has been selling bonds to pay for highways because the money has been diverted somewhere else or something like that and now the interest on these bonds each year is greater than what is spent on roads!!
Sometimes I think I’m the only person in America who votes what I believe, ie., I don’t vote for any of those fools.
Series. State of America: Our Crazy Medical Care System
The United States of America has indisputably the most complex, irrational, costly and most screwed up medical care system of any industrialized nation in the world.
As of this date, no one really knows how the Obama medical care that passed congress will work out. Heck, we don’t even know if it will become established law as it was written because it is being challenged in court by about half the states. And even if it survives court challenges, a change of political power in Congress might vote to change or abolish it. Neither scenario really matters much, believe it or not. Our medical care system is broke and the “reform” of Obamacare wasn no such thing and won’t even come close to fixing it. All it will do if it survives is make our crazy system even crazier. And here’s why:
The leftist liberals really, really believe in socialized medicine but will settle for having as many people covered as possible regardless of cost or stupidity of the system. The rightist conservatives really, really believe in free market oriented medical care, no matter how many people don’t have insurance or how stupid the system is. They also won’t believe that medical care won’t work like the free enterprise system of regular business.
I don’t particularly care for Obama as president but he did say one thing that is true. The present system is unsustainable. Then I will be damned if he didn’t go right ahead and sign a health care bill that continues on with all the old broken systems but adds a ton of more broke stuff on top of them!
Every year, medical costs go up far more than inflation. It wasn’t that many years ago that medical care cost about 10% of our national income. Now it’s nearing 20% and continues to rise. In another generation or two it will be off the charts and our entire national economy will be going for nothing but medical care if our present system continues. Why? Because costs are now so high because every step, every procedure, every item, every Insurance company has profit motive built into it plus horrendous admin costs. but it ain’t competitive! And docs with Medicare and Medicaid patients choose the procedure they’ll get paid the most for, not the easiest or least expensive. That’s the way it is.
Almost all industrialized nations have government owned medical care. Socialized medicine if you will. And know what? It only costs half of what our system does, or even less, and for most of the population gives fairly decent care. Sure, some parts of it are rationed. Sure, they don’t use every new drug that comes along when old ones still work just about as well. And sure, hospitals are a bit crowded. So what? Remember? Our present system is unsustainable!
I worked in medicine myself for about thirty years, military and civilian and have had a lot of experience in just about all segments of medicine except X-Ray. I’ve been cared for as a private patient previously and am cared for now under Medicare and Veteran’s care. I’ve seen both the good and the bad in both systems. The good is that rich folks or those willing to spend a lot of money on a very good insurance program get first class care. That’s always been the case and always will be so there’s no use griping. Just accept the fact. However, there ought to be a way to get at least halfway decent care for most of us without all the damned complications of our present system.
Why does our system of medicine cost so much? There are several reasons. A great big one is that it isn’t a single medical care system but the most awful mishmash of programs ever promulgated by politicians out for votes (well, the IRS is a hot competitor but I’ll cover it in another issue of Bainstorming). Read on and you’ll wonder why the nation isn’t already under water from paying for it instead of just rapidly heading that way.
We have Medicare but that’s not a single system like it was first conceived of to pay for part of the medical care of our elders. Our leaders kept adding more benefits until the system was bulging at the seams from more costs, then they began passing legislation time after time designed to rein in costs, but Americans aren’t stupid. For every cost-containment bill that was written, doctors and hospitals and labs and X-rays and all the other ancillary care segments of medicine quickly figured out ways to get around them.
Would you believe that in the mid-sixties when Medicare was instituted by congress it was forecast to cost only one billion dollars a year? How laughable is that when it presently costs the government about half a trillion dollars (500 billion)? That’s not even counting the drug bills and so on. But back to the system. There’s straight Medicare but then there’s A and B, hospital and outpatient. There’s co-insurance you have to buy if you want more than 80% of hospital care covered--and the way hospital costs have ballooned in order to get around “cost-containment” regulations of the system you damn well better buy it, or the first time you go into a hospital you’ll be bankrupt when you’re discharged! I remember going into a hospital for two days in 1972. It cost $357.00 total. Want to know what it would cost now? About $20,000.00!!
Think you’re finished after getting the co-insurance for Part A? Nope, that’s just for the hospital. You still have to get insurance to pay for the Part B. That’s the outpatient and ancillary part of your costs. You damn well better have it too, or you’ll be bankrupt. Of course the good old government has fixed up a system so you can buy co-insurance for both of them at once, then you’ll only have your deductible to pay. No, that’s not right. You only have your deductible to pay if you buy the most expensive insurance for part B the government regulates. If you buy the less expensive, it only covers part of the costs. Or there’s also Medicare Advantage where it’s still Medicare but all of your costs are covered, including drugs in most cases. But it’s at a higher cost to you, of course, and you don’t get to choose your doctor and you have to be vetted by cost containment people for expensive procedures, and so on and etc. The Medicare advantage programs have proliferated like fleas on a hound dog since they were instituted. And why not? Profit-oriented companies love that “free” government money! I don’t really know how to count all the Medicare Advantage programs so I won’t try. Just take my word for it that there’s plenty of them and you can pick and choose your own poison.
Just about any of those programs, the regular Medicare A or B or Medicare Advantage have that thing we just talked about called co-insurance (don’t ask me what it is, I don’t know or care and probably like you, couldn’t understand it anyway). All I know is that it costs you extra money and was thought up by Insurance Companies to make money or keep from paying you money. Suffice to say there are uncovered costs since Medicare only covers 80% of costs. So you have to buy the extra insurance if you want to be honest and pay your bills. There are several types of those, too. Some pay drug costs, or did before Medicare D and some still do but it costs. Some have deductibles of various amounts. And by the way, deductibles were invented as a way to keep people from using their insurance for every little thing but no one worries about it except for the cussing when they get a bill saying they haven’t paid it. And of course there are charges that aren’t covered by Medicare A or B or D and working on Z that you have to pay regardless but maybe not for too long. The bureaucrats keep adding things that Medicare pays for, like Chiropractors, Accupuncture, Touch Therapy that was the biggest fraud of all time, Scooters (and man, did the scooter companies jump on this and sell scooters to ten times as many people who didn’t need then as did and make jillions!), and all kinds of other far-out treatments.
Whatever type of Medicare you’re enrolled in, pieces of paper “explaining” your charges and costs will arrive in your home. There are hundreds, maybe thousands of codes for each type of care and for each explanation for each charge. You won’t understand much of what the pieces of paper tell you, so forget it. Just save them for a couple of years in case you have to have a lawyer.
Let’s move on and you just hope those codes don’t get mixed up on the Medicare computers because they’ll never straighten it out and you’ll never be able to straighten it out for them.
And now, of course, we have the Medicare Part D which covers drugs unless it happens to be the drug you’re taking then it doesn’t, ha ha. That doesn’t happen all the time but often enough--and for the most expensive drugs, of course. And I’m sure you’ve heard of the infamous donut hole. The donut hole is where, just about the time you’re thinking the money you pay for Medicare D plus your co-pay and even considering the drugs it doesn’t cover has gotten you to the break even point where you’ll begin saving money, you fall into the donut hole and have to pay for all your drugs until you pay your way out of the hole, if you ever do. And the whole thing resets each year.
Alright, enough about Medicare A, B , D and working on Z. I’m sure you’re confused enough, except--well, the bureaucrats also twisted up the system where Hospitals can charge all their X-ray machines, lab testing machines, training doctors and God only knows what else to Medicare. That’s in addition to the $10,000 a day any hospital charges for an overnight stay for an operation, a simple one. For more complex ones, the cost per day goes way, way, WAY up! Remember when I went into the hospital overnight for a simple operation in 1972 the total came to about $375.00? God only knows what it would cost now! Enough about Medicare. You’re confused and outraged enough already. Let’s look at some other parts of the Medical care system.
We have a complete VA program to take care of our veterans, which sounds great and is, mostly, but it doesn’t account for folks like me who can’t travel far and where the nearest clinic is over an hour’s drive away and the nearest hospital is two hours away and you’d have to spend the day if you take their bus. They give drugs to Vets but charge for them unless they are totally disabled. And some drugs they don’t carry, like for me they don’t carry Actos for Diabetes. Never mind. Just take VA as one more of our systems included in the mishmash.
Now we come to Medicaid, which is Medicare for the so-called indigent except the indigent live better than three fourths of the rest of the Earth’s population. Never mind. They really are indigent when it comes to paying for Medical care. No one but a zillionaire could pay it without insurance and supposedly they either can’t or don’t earn enough to buy medical insurance. Want to hear a funny? Medicaid for the indigent will probably pay for some dental bills while regular working people can’t afford a dentist unless they make more than half the people in the country.
Anyway, here the government and states split the cost of covering
those whose income is low enough to qualify them to be called poverty stricken. Sometimes they get better care than those of us who have to pay for health insurance and they don’t have deductibles, co-insurance, etc. but never mind, it’s just one more system and handled differently like all the others are. A separate bureaucracy for each.
How about the Child Insurance Health Program. This is called CHIP for short. It’s another system added onto all the others. It is also split between the feds and states and covers children who are otherwise uninsured. Don’t ask why they aren’t insured. Probably because their parents are poor but in that case, why doesn’t Medicaid cover them? Don’t ask. I sure don’t know. I think maybe because they’re insured they get a bit better care than through Medicaid. Whatever, the program comes with another big bureaucracy with all kinds of rules and regulations and it will insure kids where some of their parents are perfectly able to buy the insurance.
Are you getting the picture? Beginning to understand why medical care is bankrupting the nation? Don’t go away, we’re not finished yet. Let’s move on to Employee paid health insurance. This is where your employer pays for part of your health insurance and you pay the rest. A bunch, and going up every year. These policies are handled by a myriad of insurance companies, hundreds of them, out for a buck--and believe me you, they get their bucks! I can’t begin to list all the different kinds of policies or the insurance companies that sell them to employers, but suffice to say that all of them keep a whole hell of a lot of clerks and adjusters busy as bees keeping track. And hardly anyone is satisfied with what they have to pay or understands why they have to pay some things and not others. Nor do most of those covered by employer insurance understand all the wordy stuff they’re told any better than Medicare patients do. There are so many rules and regulations and contradictions to our medical care system that it vies with income tax for anyone being unable to understand it. And constant tinkering by congress trying to keep costs under control has never worked. Good old American ingenuity can get around any “fix” Congress ever comes up with--and has, every time! Know why? Just about anyone is smarter than our congress critters. Ha aha.
And of course there’s insurance you better buy if your employer doesn’t supply it. Be warned, you probably won’t understand what the insurance salesman tells you because there are a zillion different type of policies and all they have in common is that they all will cost you an arm and half a leg. But if you don’t have something and you get sick you’ll be bankrupt in a week. Lovely.
In the meantime, fraud is rampant in the Medicare and Medicaid system and the government hasn’t nearly enough enforcers to catch the crooks. Even when they do catch them they’ve nearly always took the taxpayers for millions or zillions of dollars, probably stuffed into off shore accounts. They go to jail for a couple of years then get out and spend all their ill gotten gains. Curses (censored). The whole system is just ripe for crooks.
Estimates of fraud in Medicare alone run from 10% to 30% of total costs. I sort of doubt it is 30% of the total but I’m sure it’s greater than 10%. Let’s agree on a figure of 20% of total costs. That comes to about 100 Billion dollars per year out of your pockets and into the pockets of crooks! Don’t like that huh? Here’s just one example.
Right here in Houston, insurance companies were billing Medicare for scooters that either weren’t delivered or not even ordered or ordered by crooked doctors getting kickbacks. I think it amounted to over a billion dollars! Multiply that by the rest of the United States and come to your own conclusion but don’t tell me. I don’t want to know. God knows how many scooters taxpayers pay for that aren’t needed nationwide. Ask any place that sells scooters and if you’re on Medicare they’ll break their necks trying to get the good ol’ government to pay for one for you, whether you need one or not.
And every day you can read in your newspaper or in on line news about another big scam. The lesser ones are so numerable that no one even bothers to report them any more. Isn’t that horrible?
Drugs are another big ticket item. Pick up any magazine or newspaper or watch television for a while and you’re bound to read or hear ads for new drugs. “Talk to your doctor”, they scream! In the meantime the drug company reps have been by to see your doc pushing these drugs. Many of them are not one whit better than what was being used and some are even worse. And they cost like hell, too. Suppose you’re in constant pain and have to take Oxycontin. You’ll pay about seven bucks a pill. If you take two a day that’s fourteen dollars a day. It winds up closer to four hundred dollars a month than three hundred. I take Actos for type two diabetes, legacy of Agent Orange from VN. Since the VA doesn’t carry it I have to buy it at four or five bucks a pill. Expensive, huh? But for a change, it’s worth it because this particular drug preserves whatever insulin production you have left and some or most of the \others don’t. Well, let’s not get carried away on drugs. They’ll break anyone except a millionaire if you are very ill and have to take four or five prescription pills a day. We don’t even want to get into all the different plans of all the different systems of coverage for drugs but the significant factor is this: If you’re sick, grab your pocketbook. You’ll need it. Even the Medicare Rx coverage is costly as hell for anyone trying to survive on Social Security. After paying the up front charges and the partial pays for drugs it still comes to a goodly sum. The dreaded donut hole will be fixed in about ten years if the government is still solvent by then and if Obamacare survives. Don’t count on it, though. And before leaving this issue I might mention that in most other countries you can buy almost any medicine over the counter at about a tenth of the cost of what we pay when it’s a prescription item. And guess what? Patients aren’t dying in the streets because they don’t have to pay a doctor to write a prescription. That ought to tell you a lot right there, huh? But the drug companies sure don’t put that information in their ads, nor do the lobbyists for the drug companies ever mention it. I could write a book about drugs since I was once a pharmacist in the army, but let’s move on.
There’s one more big factor in medical care costs. Guess what? Our medical care is inextricably tied to our legal system, with an awesome array of lawyers hanging over the shoulders of doctors and hospitals just waiting for a chance to sue their pants off at the least little error, and the doctors and hospitals have another giant array of lawyers hanging over their shoulders ready to protect them when they get sued. And they will, believe me! This results in doctors ordering a vast array of tests that aren’t really necessary but are designed to keep the doc from being sued. Hell, a doctor may know a patient doesn’t need an MRI or a throat culture or any number of other expensive procedures but they’re going to order them anyway just on the chance some little thing goes wrong and they get sued for a jillion bucks. At least that way they can say, “See, I ordered all those tests so you can’t blame me!” Hospitals do the same thing, making up more rules and regulations than the environmental projects agency and having them all on paper so that no one but lawyers ever read so they can “prove” they’ve followed all the correct procedures. In their defense, they have to have all that junk written down, not only for the lawyers but for the Joint Accreditation Association that certifies hospitals as fit to stay in. The JCA is a power unto itself that I don’t want to get into, since I don’t agree with a lot of what they do and having tangled with them before.
If our medical care is ever gong to be made affordable (and I’m speaking of affordable for the nation, not the patients) we have to get rid of that god awful barrage of litigation that drives up malpractice insurance to such heights that physicians have to raise their rates to pay for it to ridiculous heights. Right here in Texas malpractice insurance for OB/GYN docs got so high that they were abandoning that specialty or moving out of the state before a law was finally passed that made the malpractice insurance for OB/GYN docs merely astronomical instead of absolutely unaffordable. Other specialties are the same. Malpractice insurance eats up so much of a doctor’s income that they have to damn near double their fees just to pay for it. So long as lawyers are allowed to sue at the drop of a hat for every conceivable miscue, this part of medical care will keep costing taxpayers a fortune.
Want to know a deep dark secret? Less than half of all medical treatments and surgeries have been proven to be effective! Remember that next time you go see a doctor. Want to know another little secret? A lot of the procedures are actually harmful. No, you probably didn’t want to know that one, but it’s true all the same.
Alright, I’ve ranted and raved over all the crappy way the system malfunctions and costs more than twice and usually three times what any other country pays for medical care and doesn‘t get as good results! Now, then, you say, if you’re so damned smart you tell us how to do it. Right. Since you asked, I will.
First of all, since the government is already paying about half of all medical costs why in hell not just go ahead and put the government into the business and be done with it? What I propose is a government owned and run medical care system that is completely free. (Don’t stop reading until the end, please. This isn’t exactly what you imagine!!) The doctors would work for the government and the hospitals and clinics would be owned by the government. What’s the catch? None. This system would eliminate much of the overhead and bureaucracy endemic in our present insurance companies and multiple medical care systems. Only generic drugs would be used. Only necessary surgery would be performed. Only laboratory tests that were actually needed for a diagnosis would be performed. Only MRIs, Cat Scans and Pet scans really necessary for diagnosis would be performed. Nurse practitioners and physician assistants would see many of the patients, especially in rural clinics. The upshot? Anyone who wanted it could get free medical care and free drugs.
There would also be no need for malpractice insurance because I would make it a law that anyone accepting free medical care be unable to sue. We could use some of that awesome amount of money we’re presently paying lawyers to pay doctors what they’re worth. Malpractice would of course occur but I’d have it set up so there was a cap on any awards and the complaints would be handled by a board of doctors, citizens and maybe a couple of lawyers if they behaved themselves. But no more suing, not when the care is free!
But hey! Suppose doctors don’t want to work for the government! Suppose patients don’t want this cut rate medicine (which would be very nearly as good as what costs more than twice as much today). Fine! Let the doctors who don’t want to be in the system continue practicing privately. But Medicare patients would have to be in this system unless they wanted to go to a private physician and pay for it themselves. Any hospital could be private if it wanted to. Maybe they’d have enough patients to pay to fill their
expensive beds but with an alternate of free care at government hospitals, I doubt there would be very many of them.
I would suggest that the VA system and the free system be folded in together to start. The VA already works pretty good and it is a government system. It might take a while to get everything carried over but in the end we’d have two systems. One, a medical care system run and owned by the government that is absolutely free and two, private practices for patients who want to buy health insurance and go to them. No one would be forced to participate in the free system but if they wanted anything else they’d have to pay for it themselves.
I would also make many of the meds that require prescriptions available over the counter. Sure, some people might kill themselves by self treatment but that’s their problem. Why should the government try to educate them?
Oh yes! Anyone could naturally get emergency care, same as today. But anyone who can’t prove they are a citizen would be locked up after being cared for and shipped back to the country they came here illegally from! And illegals couldn’t have babies here unless it was a true emergency. Otherwise, go back to Mexico or wherever the hell you came from to have it!
Medical care costs would be cut in half. The government might eventually be able to start paying off some of the monumental money it owes. But don’t count on it. Trust the politicians to find something else to spend all the money that would be saved on something else.
Now if anyone else can come up with something better that will not break the country, have at it, but don’t tell me competition will do it. Don’t tell me that private medical savings accounts will do it. Don’t tell me that sissy, cover your ass “reforms” will do it. Just remember one thing: The present medical care system is unsustainable! It will absolutely bankrupt us all if costs continue to rise and there is no way around it except to change the system! None!
Excerpt From Alien Seeds
Note: This isn’t biographical except in the sense that I used my brother’s name and some of both our personalities as characters. Don’t anyone sue me, please.
My brother Gary has always been the adventurous one of the family, although anyone who doesn't know about him might think it's me who loves living on the edge. I’ve been involved in a few escapades, including one real war and one that never made the headlines but was real enough to those of us being shot at all the same. And I’ve traveled a lot, itchy feet being something all the men of our family have in common. I was something of a rounder in my younger days, drinking and gambling and bouncing from woman to woman and place to place while thinking I’d never find that true love the romance novels tell about. That’s not adventure, though, not the type that Gary goes looking for and all too often finds. I’m talking about jungles and mountains and deep sea diving and things like that, along with the same wars I was in. Plus an extra one he managed to find that we don't talk about too often. And he always did love prospecting, looking for gold and old coins and antiques on beaches, abandoned mines and at ancient home sites and the like as well as searching for gold nuggets in wild country all over the world. Which brings me to the point where he involved me in one of his wild man adventures, and I’m not talking about the usual, like the time he wound up in the Pacific with his new wife on a disabled dive boat going from circling sharks with hungry gleams in their cold lidless eyes to a giant typhoon that almost did them in. That’s just the usual run of life for him, not at all out of the ordinary. This time he went way beyond that.
It started with a phone call, but not from him. It was from his current girl friend, Mona Lighthouse, the latest in an untold number he'd left behind with scarcely a ripple of emotional upset on his part. She wasn’t exactly hysterical, but she was close to it, which wasn’t like her. She had been with him a couple of months ago when Gary talked her into going on a “vacation” with him. They wound up in British Columbia, high up in the Rockies, on the side of a mountain, inching their horses up a trail not fit for goats, but just the kind of terrain Gary likes to explore. In deference to Mona, he had even hired a guide, who promptly led them to that god-forsaken trail when Gary took him aside and told him Mona was really wanting to see some “wild country”. Mona had said nothing of the sort, of course, but she said a lot when they wound up at the so-called pass and it was iced over. The trail was so narrow they couldn’t even turn the horses around. Gary and the guide spent most of the daylight hours chopping ice while Mona sat on a horse, too scared to even get off and relieve herself, and slowly turning into a block of ice. She was shivering so bad she couldn’t even scream when the lead pack horse shifted its feet, touched an ice-glazed rock and tumbled down the mountain, taking the other two supply-laden horses with it. Fortunately, Gary had taken the precaution of not roping them to their own horses, but simply pulling them along with a hand rope. Once they finally got home, Mona referred to it as “The Vacation From Hell”, capital letters included. But she hadn’t gotten hysterical, even when the horses slid off the mountain. Or so he told me.
Anyway, Mona said “John, I think you better come up here and see if you can find out what’s wrong with your crazy brother.”
“What’s he doing?” I didn’t bite on the term she used to describe him. He’s been called worse things lots of times.
“Prospecting, so he says.”
“Then that’s what he’s probably doing,” I told her. Gary purely loves to hunt for gold, even though he’s never found that mother lode he keeps talking about or discovered the “lost” mines his old treasure maps refer to.
“I guess so. It the way he’s prospecting, though.”
“How?” I asked. Hell, I didn’t know but one way to prospect, and that was with a metal detector. Gary has spent a small fortune on the devices, always going for the most expensive ones, with all the bells and whistles, guaranteed to find a microgram of gold forty feet beneath solid granite if you can believe their ads.
“Well, he goes out in the morning with this detector he bought last month, then he comes home mumbling and saying he needs a microscope and he should call John, then he cusses and plays around adjusting the settings on his detector until all hours of the night and never does call you and then the next morning he goes out again. He’s acting like a crazy man.”
“That’s normal for him,” I said, trying to jolly her a little. She takes Gary too seriously. It didn’t work.
“No, it’s not, this is different from his normal crazy. He’s acting all mysterious and telling me he can’t tell me what he’s found or what he’s looking for or even where he’s looking. That’s not like him.”
Well, I had to admit it wasn’t. Normally, he likes to talk about all the gold he’s going to find with his newest toy or how he had bought a new treasure map that was “guaranteed” to be authentic. I had given up asking him where all his gold was or why the dealer was selling it if the map really did point the way to a mountain of gold or diamonds or lost Spanish treasure or a shipwreck or…well, you get what I mean. “Where are you now?” I asked. The last time I had talked to my brother he had been up in Alaska, looking for a purported Bigfoot. The only thing he found was an Inuit girl who led him astray and taught him a few new things about the frozen north that can’t be related in polite company.
“Well, we’re either in the Blue Range or The Blue Ridge, depending on which side of the state line we’re parked on.”
I had to think for a moment or two before it came to me. Combine New Mexico’s Blue Ridge Wilderness with Arizona’s Blue Range Primitive Area and you have two pieces of earth that encompass a wild, generally dry, and seemingly endless expanse of rough but beautiful terrain. The state line is all that separates the two areas, with New Mexico's Wilderness tucked into the Blue Range Mountains and halved by the Mogollon Rim, a dramatic edge of the Colorado Plateau that runs east to west. I had gone there once after my divorce to find a little solitude. That woman I had been married to could talk the cement out of a brick wall and never shut up from dawn to dusk. “That’s pretty country,” I commented, without the commercial I could have added. “Where’s Gary now?”
“How the hell should I know? He leaves before the sun comes up and won’t tell me where he’s going. Someplace in the goddamn blue yonder.”
She was really agitated. “And you say he’s wanting a microscope? Well, I can understand that. It takes one to see most of the gold he finds.”
My effort at humor fell flatter than my billfold after Joanne’s divorce lawyer got through with me.
“John, please come up here and help. I’m at my wit’s end.”
“How long has this been going on?” I temporized, not really wanting to leave my new job as the night lab tech at Women’s Hospital in Little Rock . It gave me a chance to meet lots of pretty nurses and most of the night I could loaf and work on the novel I was writing about the evils of talkative women, not that I expected it to sell. The publishing industry is mostly controlled by liberal female editors these days. That kind of book had about as much chance of being published as a baby rabbit did of surviving in the same kennel with a starving wolf. On the other hand, I had written a couple of science fiction novels good enough that a small publisher took a chance on them. And lost money. Unless they have the finances for thousands of copies to be printed and have a big advertising budget, the chain bookstores won't stock books by a small publisher. And the big publishers won't look at a book unless you have an agent. So far what little success I've enjoyed has come with e-books, the kind you download to your computer or phone or a reader. I've had two books out in print but my publisher wouldn't risk another.
“I don’t remember. Too long. He’s lost weight, too. And he carries his pistol everywhere he goes now. Wherever he goes.”
Now I was worried. Not about carrying a firearm. We've both always been partial to guns. Up in that country it’s not a bad idea, if for no other reason than rattlers and cougars. But losing weight? Not the way he liked to eat, as if the world had never heard of trans fats and bad cholesterol. I sighed. “All right, give me directions. I’ll see if I can get some time off.”
I couldn’t get any time off, so I quit, very reluctantly, telling myself Gary was going to owe me big time for this little trip, especially since I swiped one of the lab microscopes from the storeroom to take with me and would probably wind up in jail if I ever came back that way. Or maybe not—it was an older scope, relegated to the storeroom when the lab bought new ones. Besides, that goddamn intern Bonnie was seeing when I wasn’t around would probably have her locked up by the time I got back, even if finding out what was going on didn’t take that much time. I’ve got it figured out. God just doesn’t like me, any more than that intern does, so screw them both.
I shouldn’t have had that thought. I spent three hours in line at the airport, then the flight was cancelled for some goddamn reason, probably because the captain had a hangover and couldn’t fly. They should have hired Gary. He flew in the war with more than a hangover. He even got grounded once when the flight surgeon made a surprise blood alcohol check on the pilots one morning. He flunked it bigger than I busted my Physics final in pre-med, which is why I’m a lab tech now instead of a doctor. They put him back on the schedule later, though, when his replacement didn’t come back from his first mission. My brother can fly planes better drunk than most pilots can sober on their best days.
I spent the night in one of those damn plastic chairs that’re designed by crooked chiropractors to increase their business, then finally got out of Little Rock at ten o’clock the next morning. By the time my connecting flight, in a little private chartered jet, landed me at Mogollan airport that evening I was pretty well pissed at the world. Mona must have given up on me because she wasn’t there to meet me. My cell phone was dead when I tried it. When I used the phone at the airport to try calling them, I got no answer, even though it was getting late, already after dark. I finally wound up hiring one of the locals to take me to the address Mona had given me, which took just about all the cash I had left except for my emergency bundle in a safe deposit box back in Little rock I had decided to leave alone. Let Gary pay the bills; he was the reason I was here.
The local drove for about an hour along dusty, twisted roads. I just rolled down the window and smoked and cussed Mona for getting me to come and cussed Gary for making me start back smoking, and then added some more cussing just for the hell of it. It didn’t accomplish much but it made me feel better.
It was dark at the place the local let me out at, an old adobe Spanish type home that looked to still be in fair condition as near as I could tell in the headlights of the car. It was late, though, so I figured Mona and Gary had already gone to bed. I paid the man, collected my bag from the trunk and coughed out the dust from the cloud he buried me in as he sped off. It was like he wanted to get away from there in a hurry.
There wasn’t a doorbell that I could find. I knocked, waited, then knocked again, louder. No one answered. I tried the doorknob. It wasn’t locked. I guess they didn’t worry about burglars this far out in the boonies. I pushed the door open and called out. “Mona! Gary! It’s me, John!”
No answer. I tried again, louder. “Hey, anybody home? Gary? Mona?” The silence was deadly, like just before that door in the supposedly deserted mansion starts to creak. Suddenly I wished I had my gun in my hand but it was still in my bag. Besides, what did I need a gun for, I asked myself. I felt around for the light switch, found it and flicked it on. Then I knew why I wanted a gun. The door opened into a combination kitchen and living room. It had been trashed, like someone searching for hidden money. I felt goose bumps breaking out all over and they weren’t caused by the breeze coming from the door, still hanging open and making me antsy, like someone might come charging through it any moment with mayhem on their minds. I didn’t close it, though. From the looks of things I might need to clear out in a hurry—except where would I go? I was forty miles from nowhere, no transportation—no, wait. Maybe one of their cars was around in back. All I’d need to do was find the key.
I shook my head, trying to get myself to thinking straight. Damn it, I couldn’t go anywhere yet, not knowing what had happened. Besides, the house might not be as empty as it looked. I don’t know why I tried to avoid making any noise as I sat my bag down and slowly unzipped it and fumbled for my gun, a little forty caliber Smith & Wesson takeoff of the bigger .45 caliber Glock, then chuckled nervously. I had already made enough noise to rouse the dead calling out for Mona or Gary. If anyone was there, I was probably already in more trouble than a mouse at a psychologist’s convention. Nevertheless, once I had my little pistol in my hand I felt much better. That lasted only until I got to the single bedroom and pushed open the door.