Thursday, May 28, 2009

Parts Is Parts



Over Memorial Day weekend, my brothers and I hosted a big hoopla for our father's 90th. He lives in south-central Kansas where the air is pure, the water clean and the politics slightly right of Kubla Khan but just left of Genghis. We grew up in the same small town where Pop still lives. We are three sons of the high plains, a phrase that sounds like a B-western singing group.

Our father is still a very active camper. He is an insurance consultant (part time), a church choir baritone, an independent resident of a retirement community and a daily golfer (unless there is snow on the ground, tornados touching down nearby or steady rainfall greater than one inch per hour). As much as he ever had them, he retains all of his marbles. Part of his longevity success has been the replacement of critical body parts: knees (both), hip (left), arterial stents (couple), urinary tract mechanical sphincter (original plus replacement) and so forth. Since he has been older than 65 for the past 25 years, Medicare has picked up the great bulk of the expense associated with his renewal projects.

Proving that the fruit doesn't fall far from the tree, I am having a brand new titanium and stainless-steel left hip inserted into my-own-fruity-self on June 1. The surgeon appears to be no older than 17 but he assures me that he is fully qualified, certified and insured. The good news for you readers who still pay taxes is that I am not yet old enough for Medicare to pick up the tab.

As some of you already know, if all of the Baby Boomers were asked to line up based on birthday and year, with the oldest at the head of the line, I would be right up at the front with the other January 1946 (year one of the 18-year generation) geezers while Barack would be way, way back in the 77,000,000 person queue. This line of Americans will begin to depend on Medicare for replacement parts starting year after next. I could have waited until then but my intake of Advil during that time would likely pickle my liver, yet another medical expense to present to the taxpayers. That, plus I am a sensitive, altruistic guy who wants to get back to pole vaulting soon, my exercise of choice.

New body parts are expensive. Multiply "expensive" by 77 million and you get a truly impressive number. How impressive, you ask? Let's see now, multiply the 7, carry the 2....hmmmm. Yowzer!

Medicare money, which comes out of the government's general operating budget, has a projected shortfall of $80 trillion. How big is $80 trillion you ask, your eyes glazing over like they always do when very large numbers are presented? Here's a nifty comparison: all of the personal property in the U.S., houses, land, office buildings, cars, mink muffs, Rolex's, lawn tractors, art, iPods, Wii's, etc. is valued at $50 trillion. Everyone in the country could sell everything that they own (to foreign buyers because we can't sell it to each other else we would still own it) to pay for Baby Boomer Medicare expenses and we would still be $30 trillion short. Sorry Barack, your new hip is on hold because the guys at the head of line used up the money.

The entitlement shortfall is not a problem that can be tweaked to a solution. Trimming around the edges, paring a few hundred million here and there, extracting a $2 trillion pledge that "we promise (but don't guarantee) to do better over the next 10 years" from the hospitals, doctors, big pharma, medical equipment manufacturers and insurance companies amounts to chump change. It's akin to asking the 800 pound gorilla to trim down to 768 pounds knowing that we don't have room for a gorilla of any size.

Here's one solution, immediately increase payroll deductions for Medicare by 134%. Don't care for that one? O.K., hows about we immediately decrease Medicare benefits by 53%? Not to your taste either? We could ask every other Baby Boomer to off themselves prior to their 65 birthday ("Ask not what your country can do for you..."). I'm sorry, but you and your elected representatives (those unique mammals that mysteriously lose their spines upon arrival in Washington) will have to make a selection from this list or come up with some combination of the three that equates to the same outcome.

Oh, wait, I forgot the fourth choice, reigning in medical cost inflation from its current rate of about 7% annually; perhaps, you know, keeping it in line with actual cost-of- living increases which are currently 1.3% per year. Heck, we should probably allow for 3% annual health care cost inflation just to keep the industry happy. What, you don't think that the health care players would be happy with revenue inflation of more than twice the rate of the actual cost-of-living increase? Why not? Greed? Wall Street demands? Stupidity? The public demand for Rolls Royce health care for the price of a Kia and leave the grand kids to pay the difference? These are, as some of you have likely noted, rhetorical questions, each of them containing a kernel of truth. This begs the question, why do we pronounce "kernel" and "colonel" exactly the same? Very odd, that.

Dealing with health care cost inflation is the biggest piece of the Medicare liability puzzle; not all of it but the largest by far. The solution(s) for what is best for the health care of all U.S. citizens at prices that reflect sustainable reality will be at odds with the financial interests of many in the health care industry and likely at odds with some of your self-interests. We can either (1) all dig our heels in and slowly be pulled into the abyss in this financial tug-o-war with the gorilla or (2) educate ourselves about the actual alternatives and support the ones that will work, even if we have to hold our noses, or better, make some shared sacrifice.

Bruce

Observoid of the Day: Health care cost reform is not an ideological problem, it's a math problem.

Tuesday, May 5, 2009

God and Me



I had not intended to bring this topic up because of all the possible attendant media hoopla, but circumstances prevailed. So here's the revelation, I talk with God. It is not your standard, on your knees or at the dinner table, one-way communication either. In fact, it's a Jerry Falwellian type of connection. There is routine repartee. I didn't always have this communications channel; it presented itself when I changed cell phone carriers recently.

Somehow, the combination of AT&T on my office line, mixed with Sprint on the cell phone created this phenomenon. It only works when I use my cell phone within three feet of my office phone. I'm not sure whose network is responsible.

A few weeks back I misdialed my urologist's number (I can't say what that number is for obvious reasons). A pleasant and gender-neutral voice answered but it was not the receptionist at the doctor's office because she is definitely not gender-neutral, if you get my drift.

"Thank you for your call, it is very important to us. God is either away from the phone or on the line with another entity, please hold. Your expected wait time is less than 3 minutes." This was followed by music that sounded suspiciously like Jim Morrison and the Doors as covered by the Mormon Tabernacle Choir. Well, the "God" reference got my attention, so I hung on instead of up.

As you might expect, the actual wait time was less than three minutes but only by a hair. God apparently follows the dictum of, "If you can't be on time, be early." I like that.

"God speaking," came another pleasant and gender-neutral voice, except that this voice had a slight reverb, but less reverb than a Julio Eglesias recording.
"How can I help you, Bruce, or do you prefer 'Boots'?"

I was taken aback that the speaker knew who I was without introduction (probably caller I.D.) but the voice also knew that some in my family call me 'Boots' (caller I.D., not!). It was the first of several clues that eventually convinced me that I was really, actually, sure 'nuff, talking with God.

I explained that I hadn't been trying to call God and that it was an accident.

"That's often the way it works," said God. "In any case, you've reached me, so perhaps we can talk a bit and maybe learn some things. There are a number of things, for instance, that I would like to know about you."

Well, if there's something that I always spark to it's talking about myself, so I agreed.

"Why do you shave your head?" God asked. "After all, I arranged for you to have a full head of hair with only modest male pattern baldness occurring after you reached 40, but you razor it off every day or two."

I explained that the growth pattern--thin on top and back, thick on the sides--plus the aggressive graying, made me look a lot like Slobodan Milosevic, the unpopular Serb. I added that Slobodan wasn't with us anymore.

"He's not with me either." said God.

Well, anyway, I continued, now I look a lot like Ben Kingsley.

"Oh, he's the one who starred in "Gandhi", said God. " Great actor; loved him in 'Sexy Beast'. Speaking of Gandhi, now there's an interesting guy. He followed the Hindu path during his temporal years. I see him often. He tells great jokes; a real ham."

So, I observed, it is the Hindus who have the secret to eternal life.

"Well, they get lots of it right," said God, "but miss a few elements here and there. I can't fault them. They make a legit effort. And they certainly treat their cows better than most of the other earthly sects."

I asked God if this meant that there were other religions represented in heaven, or wherever God was.

"Oh sure,' God said. "We're an equal opportunity destination."

That begs the question, I continued, if it's not the specific religion that gets one there, what is the secret?

"That, I'm sure you will understand, is classified information," said God. "While this is our "Help Line" we don't offer that much help. You will have to determine the answer on your own. If we just gave out THE ANSWER willy-nilly, all of the heavy lifting of spirituality would be eliminated. After all, mental heavy lifting is the journey and the journey is the point."

This line of thought was getting a bit too circular for me so I changed the subject. I asked God if "God" was a real name or just something created by the King James translators.

"My real handle is a series of energy bursts, interspersed with dollops of space-time continuum but that doesn't translate well into any existing language. The Greeks tried but gave up and went back to nature worship," said God. "I've always been fond of 'Yahweh', 'Shaphat' and 'Jehovah' but don't care much for 'Elohim', 'El Shaddai' or 'Hupsistos'. Some of those early Jewish writers went a little overboard. 'God' works fine; I use it for autographs."

"Look," said God, "This has been instructive, Bruce, but I've got some other calls to take so let's have one more question each and pick it up another time."

I agreed and let God ask the next question.

"Why is it," asked God, "That your are so good at lag putts but miserable at anything between two and five feet?"

I said that if I knew the answer to that one that I would be a slightly wealthier man. I opined that it probably had to do with some repressed childhood trauma.

"Yeah, right," said God.

It was my turn. I asked God if the earth was really created in six days.

"I get this one all the time," said God. "Time is a relative notion. Look how far that simple concept took Einstein; Austria to Harvard with a visit to Oslo thrown in. By the way, he and Gandhi have become pals here but I, as I so often do, digress."

"Anyhow," God continued, "you have to bear in mind that eternity is really quite a long haul. Most humans have trouble with the concept. Some perspective helps. Imagine yourself sitting through an entire beginners' piano recital at Madame Eloise's School of Music. Eternity is longer than that."

For me, this was a "Wow" moment.

"Earth days," God continued, "Are merely a construct determined by the earth's rotation speed. While I was creating earth, you may recall, I was also putting the rest of universe together. Some of my other trillions of orbs rotate much faster and some much slower than earth, so the definition of 'day' gets all cockeyed once you venture out past your little patch of the Milky Way. Let's just say that the Old Testament writers did the best they could with the information that they had at the time."

"They aimed for the perfect metaphor but sometimes missed," God said. "That can be a problem, especially when interpreted too literally. For instance, I really need to spend some time resolving this snake handling business. The snakes are on my case big time."

"Well," God was obviously wrapping up the call, "It's been real, Boots. I hope you don't mind that I use the family nickname. I feel we've connected at a familial level, especially regarding the hair issue, which I fully understand. I think that you should re-evaluate the cause of the putting woes. Give my best to Mimi and the pets. Let's do this again."

Click.

I've decided not to take advantage of this communications coup by calling God weekly, although I do have many more questions. I don't want to be a pest. Even so, from time-to-time, I plan to ring God and schmooze a few minutes. When I do, I'll post a de-briefing on the blog and share it with my little corner of earth man and womankind.

Bruce

Observoid of the Day: You can watch yourself wink but you cannot watch yourself blink.