Health Care Rationing

Yesterday Teri Gross offered an excellent interview with writer T.R. Reid, who visited health care providers in several countries to assess their provision of health care. Among other things, he compares and contrasts their responses to a shoulder problem he presented. I have yet to hear the entire thing, but I'm going to try to listen today.

The section that struck me: his assertion that we, too, already ration health care ~ in response to the argument raised against reform to the effect that we will follow other countries by imposing a rationing system.

True enough, a country like great Britain rations specialized care, as he discovered when he sought advice about his shoulder. However, the trade-off is that basic care is available to everyone across the board.

We do somewhat the opposite. For some of us ~ my husband and I for example, thanks to a corporate health care package that costs us out-of-pocket "only" about $4,000 a year plus deductibles and co-pays ~ extensive and sophisticated medical care is easily available. We live within two miles of two internationally recognized and university-affiliated hospitals and we have eye and dental coverage. Our daughter's minor surgery last spring, for which the bill ran $14,000, added about $1,000 to our annual out-of-pocket costs, but it was performed by a world class surgeon who was easily accessible to us, as he had been when she had had the original surgery 18 years ago.

We as a nation are able to achieve the above because we ration health care at the outset: we simply eliminate entire groups of people from even the most basic preventative care. Our son, a restaurant server in a job in which his supervisors carefully ensure that he not work the hours that would require his employer to provide benefits, pays about $100 a month for a catastrophic plan that provides no well-person care and covers no pre-existing conditions, including any that occue under a period in which he has been covered by said plan. Actually, I'm sure that any serious illness or injury in one six-month payment period would ensure (pun intended) the loss of his minimalistic coverage and prevent him from obtaining it anywhere else. If he gets an infection that requires antibiotics, he will no doubt be out another $200 for the urgent care visit and meds. Despiter those two fabulous hospitals down the hill, he has no regular doctor as, I have heard, is the case for a huge percentage of Americans in their 20s without fulltime employment with one employer. Why would he? He can't afford the $200 I (or rather, our plan) was charged for an introductory visit to a new internist.

And he's actually in great shape ~ he lives at home and has parents who, even if he didn't, would foot the bill for his care to the extent that we could. (As we are probably about to do for flu shots, but could not do for, say, cancer.)(When my brother was 21 and uninsured, he was treated surgically for cancer; no chemo or radiation involved. The total bill at that time, more than 30 years ago, was $15,000. What might it be today?) Our city is full of people, young and old, who can't afford the $100 a month and have no one to pick up the slack for extras.

So yes, we do ration. Extensively.

Making the Transition

I had so looked forward to casting my ballot for Senator Hillary Clinton for President of the United States.

Not to be.

The fact that she is a woman played a big role in my hopes, no question about it. (Although not so big that I would have voted for a Republican to be our first woman President.) I have a photograph of the Lovely Daughter shortly before her first birthday, taken as Gloria Steinem spoke at the Chautauqua Institution. Twenty years later, the LD, like many women of her generation, eschews the term "feminist" and probably does not find it particularly remarkable that a woman and an African-American have been vying for the Democratic nomination, which I see as wonderfully indicative of the tremendous changes that we have witnessed since I was her age. Nevertheless, it would have been something had she been able to cast her first ballot for a woman.

I'm glad Hillary has conceded the nomination with grace and dignity, and I'm glad that she will be in the arena as we seek to put an end to Republican tenure in the White House. If another Republican were elected President in my lifetime, it would be too soon for me. So, while it will take me a few days to come around to the reality that Senator Obama will be our nominee, I'll get there.

But first I plan to give a little time to some grateful reflection for Hillary Clinton, for whom I would have been so honored to have voted.

Teddy Kennedy: Such Rough News

I am so very saddened to read the increasingly grim news about Senator Edward Kennedy's diagnosis. It sounds as though his cancer is a particularly vicious one (if there is such a thing), a direct attack on intellect and humor and energy.

There aren't many politicians of his ilk remaining. And whether your views and his are in sync (as in my case) or not, his passion and his energy for his work are, to use a tired phrase that in this case is true, awe-inspiring.

Robert Kennedy was the first politician who caught my attention, providing me with a vision of what politics might mean and accomplish. On the day that he was killed, I went to the town pool to do something that terrified me. I climbed to the top of the high board, looked down at the water which seemed to be about five miles beneath me, and decided that the only way that I had to honor his life was to dive in. Over and over again. I've never felt the slightest desire to dive off a high board since then, but that afternoon it was a means by which a small-town fourteen-year-old could demonstrate just the tiniest bit of courage in response to someone who had looked as though he might challenge our country to big things.

I wish I could make a high dive on behalf of Teddy Kennedy today.

Miscellaneous Thoughts on a Monday Morning

Over at a new blogring of which I am a member, it was suggested that we write about the election. I find that I have little to say. I am intrigued by the fact that my brother, a businessman and lifeling Republican, tells me that McCain is a "no-way," that he could get behind Hilary without much of a problem, and that he is utterly frustrated by the apparent reality that the Dems are choosing Obama, whom he views as "maybe ready in another eight years."

Over at Faithstones, there are a couple of posts on a book called UnChristian, which apparently reflects the reality that many young people view the church as hypercritical and judgmental and anti-gay. That's how my own three young people view it, which also intrigues me, since neither my church nor my church friends nor I could be described in that way. (Well, okay ~ I'm their mother ~ I suppose they might see me as critical at times.) The power of the media? Again? Which I hold responsible for the Obama/Clinton phenomenon? Why have my children, who have heard a lifetime series of sermons, talks, and discussions about the radical inclusivity of the gospel of Jesus Christ, and who have spent their lives in and out of the orbit of Catholic, Protestant, and Jewish friends, including a community of nuns and various members of the clergy, who have welcomed them at every turn, come to see the church as the polar opposite of the values they cherish?

This past week-end, I received a handwritten letter from a lifelong friend of my dad, who just wanted to tell me how delighted he was that I am studying for the ministry. I think he has every reason to guess that we are on opposite sides of The Issue referenced above, but he could not have been more gracious. I am always going to treasure that communication.

Our church was about to burst with the Spirit yesterday. You might have thought we were Pentecostals instead of the Frozen Chosen. Several young people from the local high school's award-winning choral program, which includes a phenomenal gospel choir, have begin to grace our sanctuary on Sunday mornings. I don't know which was better: the music, the communion, the preaching, that atmosphere of ~ ahem ~ radical inclusivity . . . I suppose it was the whole conglomeration, which actually caused a crowd of decently-and-in-order Presbies to break into applause several times.

OK, denial at work. Can you tell that I am making my major Greek presentation in a few minutes? The outline alone is 13 pages. (Things got a little out of hand this past week-end.) And would you be surprised that my take on John 21's breakfast on the beach has something to do with hospitality and inclusivity?

Hot Tub Entertainment

Six young ladies and Gannet sharing a hot tub. The girls are lovely and youthful in their bikinis and they quickly forget the middle-aged woman in their midst.

The first conversation is all about illegal immigrants, generally referred to as "they." The girls, two of whom are from California, seem to be most troubled by the reality, as they see it, that if "they" aren't allowed in, who will do the jobs that "they" do, the jobs that have become "Mexican jobs?" And further, "what about when "they" get into law school and med school and "we" don't?

The conversation is increasingly peppered with refereneces to Catholic school -- elementary, high school, and the university that the young women, from all over the country, attend. I start to wonder if anything about their Catholic education ever "took." I wonder even more when they start talking about how little they care about college.

Then more inconsistencies of youth take over. They hate lecture classes, using them mostly to do other homework. (I'm with you there, ladies.) They learn by far the most in their discussion sections. But they can't imagine the education that one of their classmates had, one of those "weird" schools where there are no lectures, no textbooks, no worksheets, where discussion is the order of the day. (The kind of school my children attended through eighth grade.)

They all send their papers home to their parents to proofread. (Now I am really laughing -- internally -- as I recall a certain mom in my teaching career who was livid when her child got a B- on a rewrite paper in my class -- a paper that, as the conversation developed, it became clear the mom had written. )

I am always after my daughter to get semi-colon and comma rules straight. But at least I seldom see her papers and then long after they've been graded. And I'm kind of glad her articulate and passionate self wasn't there for the family holiday dinner last year when an uncle and cousin went off on the immigrant issue.

I'm pretty happy about her weird education.

I am following the primaries on my trips inside from the beach and hot tub. CNN just reported record-breaking numbers of college voters in the Texas primary. Now I'm REALLY wondering how this will all turn out. I think it's incredibly exciting, regardless of your politics.

My Father Just Sent Me This