Sunday, November 27, 2016

A Noisy Bill

My son, Sam, recently suffered a fracture of one of his body's least consequential bones, the first bone of the pinkie finger of his non-dominant hand (left). All is well now, we think. The cast is off. He's back to playing the violin, showering without a bread bag serving as an improvised glove, and running around like a 10-year-old boy. Also, the cause of science has been advanced by the new life forms discovered underneath the dirtiest cast in the Western World.

A bill arrived, however, indicating that the whole saga might not be over. Apparently I owe another $100 dollars because that is the "patient's responsibility." Hmmm. I'm understandably curious why we owe another $100 after having paid a $100 copay at the hospital as well as another $25 copay to the office of the doctor who operated on Sam and put the cast in place. Perhaps this is the hospital's cut? Perhaps the doctor seeing him in office counts as a separate economic activity from the same doctor performing surgery two floors below that office the next day. I'm sure I'll find out we owe it. We'll pay.

A moment of humility: I think about how many families would have their finances wrecked by an unanticipated $225 of medical expenses. We're fortunate. And Sam's care was excellent. And when the doctor said it could be less adequately set (at probably lower expense) we didn't hesitate to have it done the right way.

Let's get back to that bill, though.


Note that there are several numbers on here. The first, $13,170 seems to be the total cost of the surgery. Next, $1,691 is the amount my insurer paid. Then there's $11,379.00 which is listed as "Write-Off." Finally we get to $100. That's our share.

Wait a minute, a write-off of $11,379? That's not a write-off. That's a decent used car. That's more than half a vacation for four to Europe. That's a semester of tuition at a public university. That's months' accumulation of wages for someone earning minimum wage. That's a lot of money.

I don't know much about what medical technology and expertise cost. However, $1,691 seems like a relatively small sum for the expertise, labor, and technology involved in my son's procedure. $13,170 seems grossly inflated.

So, what's the real price? I haven't a clue.

I've spent a lot of time contemplating the cost of medical coverage in the U.S. I followed the debate over Obamacare with rapt attention. I've followed news on it since it's been enacted. I examine carefully what politicians say about it and attempts to reform it. I've also moved through a spectrum of opinions on that measure, from outright objection to it to acceptance of it. Generally, I want to let the markets use the pricing mechanism to determine what we make, how we should make it, and who should get what we make. A marketplace, however, relies on prices acting as signals to the participants. Prices rising or falling in particular ways cue producers and consumers to more wisely use the resources available. But markets fail to work well when price signals can't cut through noise that distracts from prudent decision-making. And markets fail even more profoundly when the prices become noise themselves. And that's where we might just be with health coverage in our country.

We heard before the election that Obamacare premiums were spiking by 25% or more. But then we heard (at a quieter volume) that government subsidies would pick up some of that increase.

We hear about mandates and Cadillac taxes. Regulations, too. We hear about premiums, deductibles, and co-pays. It's a lot of jargon that most of us partially understand. It's a lot of economic reality that families experience to different degrees of severity. My eyes are more aware of it now that I went through a broken pinkie finger with my son.

There's no such thing as a free lunch. Those lunches only get more expensive when the cost is obscured, passed on, and "written off."

Wednesday, November 23, 2016

Worth Every Penny

My renewal for The Week magazine came due, and I contemplated for a moment not renewing. Though I love the publication, my school subscribes to it and I could rely on that instead. But the clincher for me renewing it involves my son's growing interest in the news. Every week he looks forward to its arrival so he can peruse the cartoons. This past week's were especially good.

The one at bottom right I think was the best this week.
In fact, the cartoons inspired Sam to create his own commentary.

Note how JFK's ghost has a bullet hole so you can start to tell who is who.

They got me for another year.

Sunday, November 20, 2016

My weekly Lutheran comment


Okay, peeps, here I go with something of a rant. Not theological, mind you. Really more about church manners. Other mainline Protestants might see something in this too.

Recently I had cause to attend a worship service I knew I couldn't stay for the end of. Schedule conflict. But someone I knew was being baptized and I thought (correctly) that I could stay through the baptism before I had to hit the road for my work duty (chaperoning a play). This was the perfect, I mean, perfect reason to sit at a back corner of the church so I wouldn't disturb other worshipers when, inevitably, I would have to leave early.

Alas, it was impossible. The back rows were nearly full. Middle rows weren't. One back row was entirely full, another was mostly, with a few seats toward the middle.

I settled for an organ bench, in the corner.

So, faithful readers, may I exhort you in this 500th year of celebrating the Reformation, can we consider moving as far front and center as possible? It might be a more welcoming act than meets the eye.

democracy is hard work

I've had two difficult conversations since the election has passed with individuals who voted for Trump. Most recently it was with a friend who was bothered by those protesting Trump's victory. I actually shared more of his perspective than he might have realized. Certainly chatting with this friend was easier than the other conversation where my barber was shocked that I was such an elitist that I'd vote for Hillary.

Back to the more recent talk, though. Democracy is hard work. And for those who supported the losing side in an election, there is hard work to do when the election is done. Namely, it's important that those citizens . . .

follow the news (which doesn't mean commenting on every story: it's important to be conversant, not controversial)

support professional journalism (actually subscribing or otherwise paying for good news)

vote in every election, even odd-year primaries; every vote matters

keep humble in knowing that no party or faction owns a monopoly on truth

These are good things to do, too, if one is on the winning side.

By the way, if one keeps their eyes open right now, there's some very useful autopsy results from the election. The results of this election revealed some blind spots in the Democrats' strategy and tactics. They (and the Republicans) were guilty of missing some long-run big-picture trends that matter, and matter a lot. Perhaps the best one I saw today is this one from the New York Times. 

Tuesday, November 15, 2016

Insights

A week has passed, hasn't it?

I've been a junkie for news ever since I can remember. It's nice that my career compliments this interest: especially since joining the high school it's crucial that I stay ahead of pace with the news. So I get to marry fun and work. Though the election had a way of souring the news for me. It sapped my enjoyment of reading it and by the final week I was reading it out of routine and hope than pleasure.

It might take a while until I have that enjoyment for the news again.

Two particular insights from the news have struck me the most powerfully as I make sense of the most recent election.

First, from a news site I almost never consult: Glenn Beck's website. Okay, it's commentary, not news. But one writer there offered a particularly helpful angle on understanding the election:


Did the opponents of Mrs. Clinton overstate her potential triumph as something threatening their survival? It's possible. But I don't know if I'm in a position to judge on that point. However, the election was, very much, for me a moral one. And I think that helps explain why the hurt and disappointment are so profound. My vote for her was a stand against something that I didn't want to see our country to be.

Next, an analysis by the Economist offered this chilling perspective while analyzing Democrats' options for leadership as they move forward.


"Witch-burning atmosphere" is damning but accurate. And as the campaign reached its crescendo, it's the tone that I couldn't mistake regarding Mr. Trump's rallies. There are many of Mr. Trump's supporters who bristle at the allegations of sexism or racism (directed at President Obama) in his campaign. Those who point to it are often labeled as elitists. To many of us, though, the tone was unmistakable. And it was a tone that wasn't entirely new. To wit: one passionate opponent of the president has a sign like this along the highway near my parents:


And then I remember seeing this tasteless poster last summer near Ricketts Glen:


Tone matters. Dog whistles matter. The tone, words, and atmosphere of Mr. Trump's campaign made me look at this election as a moral stand.

I could be witty and call to mind the famous witch scene from Monty Python's film. I'd rather, though, draw a parallel between this election and a somewhat obscure western, the Ox Bow Incident. Will our country at some point reflect on the shame of what just took place the way characters in that film do when the hanging is done.

. . .

There's some good that will come from this election. The Democrats paid an awfully steep price for overlooking an aggrieved class. I can separate the tone of the campaign (which I cannot respect) as well as the implicit sexism and racism of some opponents to the Democrats from the legitimate grievances that motivated many more to pull the lever for Mr. Trump. Those grievances I respect, and out of respect for those economic grievances I'm sad that Mr. Trump's policy solutions are thin, hollow, and ultimately not the remedies for what ails them. As Americans, we can learn to better listen to the grievances of groups we overlook.

. . .

I think that's it for my commentary on this election. I'm fatigued. Ready to look to something more interesting. Ready to look for ways I can not overlook aggrieved classes in our country. Ready to be kind. And ready to read the commentaries that mean so much to me as we evaluate a new presidency that starts on January 20.

Saturday, November 12, 2016

Words Matter

As we work ourselves through the rubble of a cataclysmic election which followed the most hostile campaign in modern memory, it's good to see our political leaders take a congenial, conciliatory tone. I also appreciate the sentiments of so many who cast votes for Mr. Trump in their attempts to reach out and urge that there be no hard feelings. I've personally encountered very little boasting, bragging, and insulting since the election concluded (though the news and second-hand accounts I trust tell me of some very unsettling nastiness . . . here's one from a local newspaper about racist and antisemitic ramblings at a suburban public school). 

I urge my fellow Americans to understand, though, the perspective of someone who will have a hard time moving past the rhetoric of this campaign. Though I fit the profile of a Democrat and Clinton supporter in some ways (middle or upper-middle class, college educated, employed in the public sector, member of a public sector union), and in at least one conversation recently was cast as elitist for having supported her, there are many ways in which I don't fit that mold. I entered this campaign as a registered Republican. I voted for Romney in 2012, for McCain in 2008. I had only one chance to vote against Bill Clinton and exercised it in 1996. I voted twice for George Bush. For much of my adult life I characterized myself as a conservative, but prefer the label moderate today. 

I also at first supported Jeb Bush in the Republican primaries. When he fell to the side, I looked to Marco Rubio next as the candidate I wanted. He had dropped out by the time the primaries came to Pennsylvania at which time I voted for John Kasich. And then in the general election I voted Hillary. You're reading the post of someone who is 0-4 in 2016. 

And that winless run was joyless, too. I saw Mr. Trump demean, mock really, Jeb for being "low energy." Marco? Marco wasn't man enough for Mr. Trump. Little Marco with his little hands was how that campaign ended. Kasich wasn't in the limelight long enough to be laid low by Trump's words the way the previous two were. But the mean-spiritedness hit its crescendo with Mrs. Clinton: "Lock Her Up," Crooked Hillary, "Nasty Woman" who was more dishonest and criminal than even Richard Nixon. The pattern by which he brought down this series of opponents, people I supported, was a pattern of bullying. And I draw that conclusion just from observing (not objectively, mind you) the treatment of these four opponents. 

So, words matter. In my first teaching assignment, the assistant principal often reminded us that words are a reflection of character. It was true for me early in my teaching career. It remains true for me now as a citizen, father, teacher, and friend. It's true for the politicians we look to lead (and for the politicians who look for our support). 

One of the most helpful articles I've read since the election pointed to a basic difference between those who voted for Trump vs. those who voted against. That writer said that those who cast a vote for Hillary were often casting a moral vote. Those who voted for Trump were casting a vote for survival. If such a simplification is accurate, I won't argue that one (morality or survival) is more correct than another. It depends on where one sits, I suppose. 

As a people, we will make a great mistake if words don't matter. It's important that citizens hold politicians accountable for the words and tone of their campaigns and administration. We acknowledge the bare-knuckle arena in which politics must often take place. But we must also look to those politicians to own their rhetoric, meaningfully reach out to groups that feel damaged by it, and reign in the most rabid supporters and surrogates. 

As an American I need to hope and pray that Donald Trump is a good president. I need to hope that he proves me wrong, that his promises, words, and tone from the campaign aren't as sinister or harmful as I think they are. And, at some point, I need to forgive him for the harm he caused, indirectly, to me. Forgiveness, to paraphrase a religious book I read some time ago, means I don't prevent him from doing good or being useful. Forgiveness, also, doesn't imply forgetting. It would be a mistake for us to forget as we forgive. 

Wednesday, November 9, 2016

Bluer

Ugh. What disappointment.


I went to bed around 11:15, seeing the election sliding away from Mrs. Clinton. Slept very, very fitfully. It almost wasn't sleep. Awoke to the surprise that Pennsylvania (Pennsylvania!) had gone red. Stunner.

At some point I'll be able to engage in sober, rational analysis about why Mrs. Clinton lost. The missed opportunities. The tactics that could've maybe delivered victory. This is not the time.

I'm less emotional than I was twenty-four hours ago, but still quite angry. It's more like a cool but persistent resentment and disgust. Though I applaud Mrs. Clinton for her conciliatory tone, I feel anger over the scars that Mr. Trump and his supporters are leaving. Therefore, I pose these questions for Mr. Trump and his supporters to ponder:

1) To what extent will the aggression and insensitivity exhibited in the campaign (i.e. "Trump that Bitch" and "Lock Her Up") be a part of the White House?

2) What steps will Mr. Trump make to rein in the racially and ethnically insensitive words and tone of his campaign and his followers now that he's president?

3) Will the administration continue to threaten the press with limiting their access Mr. Trump and his White House as they attempted to do in the campaign? Will the administration threaten to use civil and criminal legal action against opponents?

4) What steps will Mr. Trump take to be more sensitive to the needs and concerns of women?

Mr. Trump and his supporters waged a nasty, nasty campaign. They need to own that and fix that, or else this will be a short, disfunctional presidency. And we, as citizens, need to do all in our power to remain vigilant, calling them on the base, crude behaviors they normalized during their successful run to the White House.