Health Care

Lots of talk about health care these days. Large numbers of the US population hate the new laws relating to health care. Others think the new laws are too little and not comprehensive enough. What both "sides" do not seem to understand is that we already have a hybrid system.

Medicaid/medicare/CHIP/etc. already make it a non-free market system. Prices are set and this affects everything-how much private pay is charged, how much insurances are charged, etc. Do not think for a second we have a free market. Additionally the US policies of the mid 20th century led to employer based insurance. Not a free insurance market. I pretty much "have to" buy my employers choices. These choices are based on what is financially best first for an insurance company and secondly what is best for the company/employer. The least and last consideration is often the one who buys the policy-even when the employer "pays" the insurance, they do it in exchange for your employment. So free market is not even close to describing our system. Its partial government mandates combined with government restraint.

So do we have a true "one payer system"? Of course not-there is money to be made-and not on delivering health care-but in administration and denial as such. Obviously many are denied care/coverage for treatable diseases and injury. Also many receive therapy that has no basis in medical literature or poor underlying information or outright quackery.

I am not sure what will be the best system. I am sure that this hybrid monster is not the best solution. A true free market system would be politically impossible. Complete one payer system in the US would be worse than Canada and the UK by several orders of magnitude for reasons that I do not want to get into now but primarily have to do with our lifestyle choices and our lack of accountability or responsibility. Answer-more flailing-and keep everybody unhappy.

From a recent club table tennis night

Biggest weaknesses-September 2010

1. Return of serves-especially long sidespin
2. Missing my serves while trying to be “tight”
3. Fatigue after 2 or 3 matches

Economy

My long term belief is that going into medicine is bad. Very bad. There always seemed to be much easier ways to earn a living. Now I am not so sure. It seems in the current economy you need to have a significant skill to get or keep a job. This is counter balanced by the ever growing regulations being put on doctors and hospitals that are all about patient safety, but which actually are more about justifying the regulators existence than improving patient safety.

This is all theoretical, but here are real life examples from the last month of my life

1. Our hospital lab is inspected by a certain organization every 2 years. This year we were given a "bad mark" for violating a standard that says we do not document that our cytology slide readers (in our case, pathologists) do not read more than 100 slides in 24 hours. This standard comes out of the old Pap smear mills that read way too many slides a day (probably in part cause re-imbursement is so bad) to do an adequate job. So the standard sounds good, fresh eyes are better than tired ones. Except we did not read pap smears. We do not have 100 cytology slides a month on average. It is physically impossible for us to get that many slides a day. I have never had even 20 slides in one day. But now we have to do a quarterly report documented that we did not do something that currently is physically impossible to do.

2. We have procedures for all lab tests. We were also cited for not having a "document system" that can document that we keep up with all procedures-the who and when of when a document was written, reviewed, etc. This would require a person working literally full time, or we can go with one of the many computer vendors for a low value system that costs a minimum of 3000 dollars a month. This is money that has to come from somewhere. It sure does not help patient care. It helps us document to inspectors that we are doing our job.

Maybe becoming a national news anchor is a better idea now that I think of it.

Missin'

Missing my running and biking friends. Not as in I wish I could see them. Just miss going running and biking with them. I don't think I will be able to do such for a long time. In some cases never.

Kids, Parenting, and Bears, Oh My!

Anyone who knows us, knows the my weakest link is parenting. We have struggled with that over the last several years. The struggle continues. Like the book of Job suggests and Ecclesiastes suggests there are things God knows that we do not. Maybe it is best to not ask some of the questions. I don't struggle too much with what is God doing in Barbs life or mine. But I do struggle with what He is doing in our kids lives via this accident. My belief in Gods sovereign providence is extends to ALL. This accident is not His accident, but within His sovereign will for Barb and I. But also for our kids and all those around us.

I cannot understand much of what He is doing-but for the kids and parenting them, I understand nothing. Has this been an opportunity for growth that I have failed them? Is it their failure? How does being further handicapped in parenting help? How does Hannah fit into all this? We believe God sent her to us-but are we failing her? We cannot physically parent all these kids like we feel we need to. We certainly see no positive parenting results. We do not see where He is going with this-we sure can't cooperate with where He leads.

I miss

I miss being able to go to be early...

I miss sleeping on the couch when the Mrs. and I fight...

Its the little things ne misses.

Kids-Don't worry

Whenever I worry about the kids, I must keep what Job said (chapter 21) in mind:

²³ One man dies in full vigor, completely secure and at ease,

²⁴ his body well nourished, his bones rich with marrow.

²⁵ Another man dies in bitterness of soul, never having enjoyed anything good.

²⁶ Side by side they lie in the dust, and worms cover them both.

46

Last night, the thought of turning 46 in a few months really got to me. A "past midlife" crisis? Maybe. I do not like how life is flying by before I get a chance to enjoy it. Being on call less than 50% of the time has more appeal than ever.