Tuesday, January 22, 2008

Consolidarity: The Sequel

[Note: This article is a follow-up to a previously published article that can be found at below -- "Consolidarity."]
I went to see my friend Johnny last night. He's been my friend for seven years. Johnny was, I think, a victim of multiple sclerosis. He was always in his wheelchair, and it was difficult for him to present a hand to shake, but I soon found he did not like a pat on the shoulder. So I waited for the hand. He had a special name he called me -- one that no one else used. He also had one for my wife. Johnny liked to sing when I came to visit him. No one could understand the words, except, maybe, him. His conversation was fully understandable, but his singing; well, nobody liked his singing, except maybe me. Some of the other residents of the nursing home would clap their hands over their ears and tell him to be quiet, but he just kept smiling and singing.

Johnny loved the Dallas Cowboys, and rooted for them through thick and thin. He could tolerate their repulsive owner, and he forgave them for putting T.O. on their team, something that I cannot bring myself to do. Johnny was one of the best fans the Cowboys have ever had. He was devastated by their loss to the Giants.

Why am I talking in the past tense? Because I went to visit Johnny at the funeral home last night. Instead of a suit and tie, they had dressed him in his Dallas Cowboys shirt, with Tony Romo's name and #9 on it, and wearing his warm-ups. It was totally appropriate, and I appreciate his family knowing him well enough to dress him that way.

Johnny was not killed by anyone. He was not a victim of foul play. He was only a "result" of a business decision. Since they "consolidated" our local nursing home with the big one in the nearest town, three of my friends have died. The move, combined with poor health, was too much for them. I don't really hold anyone liable. Johnny never really recovered after the Cowboys' loss, so I would have to blame Tony Romo as well.

But I cannot shake the idea that Johnny would still be around if he had not been so suddenly uprooted with absolutely no advance notice. Yes, I know that things like this often have to happen, but to the most vulnerable in our society, do they have to happen so fast? Johnny is a representative of what can happen to all of us. You're sitting at your desk, at a job you like (or tolerate), and saving up for retirement in, say, 10 years, when one day, your boss comes in and says, "You've done a great job, but we've just been bought out, and the parent company is downsizing." You find you have a week to start looking for a new job. At least you will probably get a severance or a "buy out."

Johnny didn't. He just got moved. Right in the middle of a serious bout with a cold or flu virus. From his home for the last (at least) 7 years, to a hospital, and then to another room he had never been in. He had to die in a strange room. With an unknown roommate (a space-saving, cost-saving move, I might add). His last roommate had been his mother, who died four years ago.

So Johnny got consolidated, along with about 30 others, and at least three have already died. I used to do a little gardening, and I know what a transplant can do to a young, tender plant. You have to shelter them from the sun and elements for a while, give them extra care, and even then, you'll lose a few. I'm amazed at how many are being displaced by "productive fiscal decisions" in our own culture.

Years ago, when I was in graduate school, I worked my way through it by being an imported food vendor. I serviced a major grocery chain. The stores had a "Midas" touch -- through great marketing and "location, location, location," they grew. Thousands worked for them. I was surprised when, suddenly, in the early 1990's, they were just -- gone.

What caused their demise? Incompetence? No. Change in demographics? Economic downturns? None of that. They were merely "bought," or absorbed, by a wealthy corporation, then they were stripped of their assets, and the rest was sold off. I don't know what happened to the friends I had made during that time, who were working their way up in a productive, promising corporation. The stores were great, but consolidation ransacked them. Somebody made billions of dollars, but we all lost in the long run.

I don't think the huge conglomerate that bought all of these nursing homes made "billions," but they did cut costs, and probably were able to "downsize" a little. I also found out yesterday that the four or five in the old nursing home that did not get out within the weeks' time they were given had no heat in the place after the eviction date. Somehow, I thought "care" centers could do better than that.

Johnny will be buried today some time after 2:00. He looked great just three weeks ago, the last time I shook his hand and we talked about the Cowboys and the Super Bowl. At least I have the assurance of his burial in a traditional cemetery. I recently attended the funerals of an aunt and uncle who were buried in a "consolidated" one. He is eight or nine feet below ground; she is six feet. They don't take up much space in that cemetery; they don't bother too many people, and they serve a "cost effective" purpose. And isn't that why we all love consolidation so much?

Tuesday, January 15, 2008

Something I Never Thought I'd Do

Well, take note of this moment in history. I'm coming down on the side of Hillary Clinton. I do not like her federalist views, her pro-death politics, or her anti-family rhetoric, and we don't need another foul-mouthed president, which she is.

But she is not a racist. Anyone who can take her references to Martin Luther King and LBJ and somehow misinterpret them as racism is an idiot. An idiot. Did I say it loudly enough? An idiot!! Interestingly, this morning, I saw that the general concensus has always been what she said. I am also an English teacher, and this morning, I was playing an introductory video for Martin Luther King's valedictory speech, "I have seen the Promised Land." The intro video makes note of the role that President Johnson made in signing civil rights legislation into effect. It even shows the same pictures that ABC and CNN did this morning.

There is nothing racist about what she said. Does anyone really think it's racist to include LBJ in a history of the civil rights movement? She didn't say what she's accused of saying: that a white male was needed to bring about civil rights legislation. She didn't say that, but it's the truth anyway. In 1964, even a charismatic figure like MLK couldn't have done it alone. It was the consciences of those white males whose hearts he pricked, that realized that the stupidity had to stop. Martin Luther King was a master at touching the hearts of "those in control." There's nothing racist about that. There's a lot heroic about it.

I wonder what history would have been like for the last 40 years if Dr. King had not died. It would have been different. Like many great leaders, he left no great men to take his place. Jesse Jackson was a cheap counterfeit of all that MLK stood for. This morning my students watching the video said, "Dr. King sounds like Jesse Jackson." I, in as simple, non-offensive terms as possible, told them, "No, Jesse Jackson sounds a little like Dr. King. He came first." What I wanted to tell them was that Rev. Jackson is a buffoon who has spent his whole life doing a substandard impersonation of a great man, much as Rich Little used to do of Richard Nixon. Al Sharpton is a joke as well. I can't see King approving of their self-centered ego trips.

And I think King would be disappointed with the turn that the so-called "civil rights" movement has taken. The hypersensitivity of it does more damage than the klan ever thought to inflict. A sportscaster, in an idle moment, makes a comment on Tiger Woods' greatness, and gets suspended. Al Sharpton calls for everything but her execution. Woods says it's all okay; she's a friend, but Know-It-Al says that there's a price to pay. It's called the scrapping of the first amendment guarantee of freedom of speech.

I don't mind saying it again. Anyone who thinks Hillary's comment was racist, or even racially insensitive, is an IDIOT. With zeroes on it. Even the president of BET has acknowledged the stupidity of such a conclusion, and it does my heart good to know that there are wise people in all races, political persuasions, and parties.

But it's sad to know that the loudest people of all are the hair-brained idiots that can take a politically neutral statement of historical fact and accuse someone of being racially insensitive. And get noticed by the media.

Don't gloat at Hillary on this one. She was correct. She's innocent of any wrongdoing, and like any American public figure, she deserves to be respected for what she said. She says some stupid things sometimes, in my opinion, but this was not one of those times. Give her a break on this one.

Monday, January 14, 2008


It was just a little thing: a little nursing home composed of little people in a little town -- definitely not nearly as important as Britney whats-her-name's latest journey into rehab that made the news above the Middle East last week.

But it was important to those it affected. In a little town near where I live, with a little nursing home that used to be a little hospital, filled with little people who used to be housewives, school teachers, farmers, salesmen, writers, carpenters, and blacksmiths, something happened. Those former people are now line items of government funding that pays salaries of medical workers who give them their medicines, turn them in their beds, and occasionally give them a bath or take them to the restroom.

I've been amazed at the life that was still there when someone took the time to sit with them for a while and just listen. That little nursing home was only half full of patients. They had even converted most of the empty rooms to office space, maintenance headquarters, and storage rooms -- oh, yes, and a break room with coke machines and tables where the residents, who pay more daily than they would for an ocean cruise, were forbidden to enter unless lucky enough to be pushed in there by someone of my size and relative influence.

I felt at home there. I could sit in the living room with them, or go to their personal rooms and sit with them. I would hold my breath for the occasional waft of detergent and urine smell that I somehow think could have been removed. Sometimes I would go down to the dining room, pour myself a cup of coffee, and converse with them as they played dominoes or just sat and visited.

Then, the same week as Christmas, they were told that they all had to be out in the next 7 days. But it was okay. The big parent company that owns several nursing homes and knows how to soak them for the maximum in government money, was going to safely move them to the bigger home in the bigger nearby city.

I went there last week, looking for them. I found a few, though many were just names on the door. They are not there -- still in transit somewhere. The old place has yellow tape around it and stock trailers moving out furniture and equipment. The few I found smiled as they recognized me. I tried to visit with one of them in the lobby, but it was hard to do. It was too noisy. They had wheeled several older ones to watch the Cartoon Network, featuring "Spongebob Squarepants" and some act of violence against a Fred Flintstone lookalike. I wondered if anybody even cared whether these old people were being cared for.

The highly efficient staff asked me at least five times, "Can I help you, sir?" The translation, of course, is "You are not needed here." I wheeled one of my friends through the hallway. He wanted to see if there was a new place he could look out the window and see the occasional truck pass by like he used to do. I was checking the tags on the doors, trying to find my old friends. I was told at least three times that my friend "belonged" in the other wing. I stopped trying to explain. I really felt out of place in this geriatric processing unit.

I couldn't pour myself a cup of coffee in this place. I still haven't found a soda machine so I can slip one of my friends a forbidden Dr. Pepper before I leave. And I grieve one more piece of my life being cut off and thrown away.

Of course, it's for our own good. It's called "consolidation," which means sweeping up little things into bigger piles for easier disposal. Fifty years ago, we did it for our schools, to make education better. Of course, the people who could send us to the moon and back grew up in "pre-consolidated" schools. Consolidated schools teach about diversity and condom usage, and we wonder why things are not as good as they "used to be."

The nursing home building in the old place was actually a hospital that was built by a doctor in that small town so many years ago. It's easy to tell, because his old house was across the street, and when I sat on the front porch, sunning myself with my elderly friends, I would admire the construction of the old two-story house, built from the same stones. The doctor lived across the street because he wanted to be near his work. Of course, they had to shut that hospital down a generation ago and sent patients to hospitals twenty miles away, where they are now sent by helicopter to even bigger hospitals 200-300 miles away to get "quality" medical care.

We have been "consolidated" to absurdity. Buy a pencil, and it comes from a corporate warehouse in a big city that imported it from China. Remember when you could buy a food item, and it was the only thing the company made? Now it's a product from a division that's a subdivision of another entity which in turn belongs to another corporation with a hyphenated name. Everything you eat and drink, or take as medication, can be traced back to two or three worldwide mega-corporations who have never heard of you or the town you live in.

Now they are processing people. The day they closed the local nursing home, they also combined the only two in my old hometown. It seems the same corporation owned them, too. They did some type of consolidation that drove down costs while maintaining profit.

By the way, the bigger nursing home in the bigger town has a nice, corporate, enhanced soap-and-urine smell that way outdoes the old one.

Why consolidation? It's easier to control, it's less personal so you don't get mixed up with actual people, and it's way more profitable. And it's killed community hospitals, elderly care, small town schools, mom and pop operations, and ultimately, us!

Of course, our government has consolidated, too. States are no longer states, but administrative districts of an ever-increasing federal government. It's all around us. What can I do about it? First, call on all of us to maintain some form of individuality, to fiercely refuse to be labeled by the "consolidators," and to walk away from the hometown bank when the big corporation buys it -- at least until we don't have a choice; to pay a higher price when something says "Made in USA," and to tell your doctor you don't need another test somewhere else -- that the reason you came to your hometown clinic is because this is where you live.

I wonder if I'll ever spend another tranquil day with my elderly friends. They don't last too long, anyway, but I could always find new ones in my hometown nursing home. Now I will have to find new ways to acquaint myself with them -- after they clear processing, and before they are taken away to the showers.

Monday, January 7, 2008

Finding Money to Feed the Monster

I watched my first political debates Saturday. There are several reasons these were the first. To begin with, I don't believe there should be any debates in an election year before the actual election year. Secondly, it was on a Saturday night, instead of Sunday, when people should have other, more restful things to do. Thirdly, it was moderated by Charlie Gibson, who, if he were running, would be my candidate of choice, regardless of his party. He looked better than anyone behind the desks.

While much of the debate was mildly entertaining, not really much was accomplished. Sure, they say that Romney and Clinton took a beating, but after all, this is New Hampshire, and by Super Tuesday, these delegates won't even matter. It was the same with Iowa. The Caucus meant even less. The dirty secret seems to be that, even though she finished third, Hilary actually garnered the most delegates. I must admit that, first, I wouldn't know why, and second, I don't even know if that's true. One reason to doubt it is because Obama hasn't thrown a fit about it.

So what did I learn from the debates? That no one has a real health care plan. Don't get me wrong. I think everyone talked about health care, though I can't remember what Richardson said. But, for all the differences that the Democrats and Republicans have, they have one thing in common. When they hear "health care," the only thing they see is insurance. If I heard right, Romney, McCain, Huckabee, Giuliani, et. al. want to make sure that the government makes health insurance available to everyone. They have different methods, but really, they all end up in the same dark alley, which will be familiar to the American taxpayer, as he has been mugged there before. The Democrats, on the other hand, don't want to facilitate health care; they want to be health care. Whereas the Republicans just want to roll you and leave you face down without your wallet, the Democrats want to make sure you never get up. Lest that be considered favoritism of one party's plan over another, let me quickly say that both plans will kill what little health care that is currently available to self-sufficient American citizens.

The problem is that they are going to insurance first. That was never intended. If you are under 40 and reading this article, it may come as a surprise to you that there was a time it did not take a day's wages to visit your doctor at the local clinic. Amazingly, for that low price, he could get everything done in one visit, and many times, he didn't even have to write a prescription because he had fixed everything in his office.

I blame insurance for the current medical crisis in our country, but not for the same reasons as the candidates did Saturday night. To them, it is the big, ugly insurance conglomerate that is taking our money and then refusing to pay our medical bills. While I acknowledge that there is much that needs to be changed in the insurance industry, let's see how they got there.

For that, I would like to take you to an emergency room visit two years ago with one of my own children. We thought he had fractured a femur; thankfully, he had only bruised it, and we received quality medical care. The sign at the emergency room told us that the fee was 200 dollars. I didn't worry too much, because my policy at the time paid up to 200 dollars for an ER visit. However, I got a bill for 250 dollars. Does that mean they added fifty dollars to my bill? Of course not! That would be unethical! They actually added 250 dollars to my bill. You see, that sign was for the uninsured. When you have insurance, your company is billed 450 dollars. After my company paid the bill, I had to pay the difference. If I had just not told them I had insurance (at a cost of 550 a month at the time), I could have gotten off for fifty dollars less. I have a new company now, and we have an agreement. The ER never sees my insurance card. They just send me a bill, which I pay and then send to my insurance company, who reimburses me.

My doctor's office wanted to see my card on the last visit. I said I didn't have one. "Oh," she said, "Surely you have insurance." I explained that I had only hospitalization, that I had no copay or other help. She still wanted to see the card because, in her words, "We often can still get something from them." I refused, and she shrugged and hit the "print" key. I had already written the 75 dollar check, and saw the bill for 60 dollars. I quietly flipped past that check and wrote one for fifteen dollars less than the little blue sign over the cash register said. Why? Because it's cheaper when you don't have insurance.

I want to tell everyone the truth, a truth so clear that I don't understand why no one in Washington sees it: our number one culprit of higher medical costs is the abundant availability of insurance plans, and the medical community's abuse of it. Have you ever been billed by a hospital after your insurance had already paid them? I have, and I'll bet you your next month's premium you have, too. Those of you in big company group insurance plans don't count. In those, the hospital just double-bills the insurance company, and usually gets it.

If we try to solve the medical care crisis by increasing insurance coverage and funding it with phantom government dollars, Huckabee's statement will soon be truth instead of hyperbole: a kleenex will be a thousand dollars. In the 1970's it was 15000 dollars for an allen wrench in a military contract, or 800 dollars for a hammer or commode seat. We've seen how providers work when they have government deep pockets to pick.

I would like to see one person attack the real problem: actual medical costs. It has been too easy for 40 years: if insurance is paying it, we don't worry about the cost. I know a man who is in great shape for his 80 years, who was confronted by his doctor who wanted to run an unnecessary test. After being told that, one, he didn't need it, and two, it was expensive, the doctor responded, "Why worry? Your medicare will pay for it!"

I have a solution to the health care crisis, but I know it's unworkable. If tomorrow morning, every American canceled his or her insurance coverage, opted out of medicare and medicaid, it would be a rough six months, after which, the prices for medical care would start to plummet toward reasonable rates.

Major insurance companies and medicare are, at this moment, food for a ravenous beast, a growing medical culture that demands ever-higher prices. Local hospitals and clinics are closing, and family doctors are moving from the small cities. Medical treatments take more than one visit now, and doctors are specialized and require that we be bounced from clinic to clinic. True specialists won't see us until we pay another doctor a hundred dollars to recommend us to him.

And we do it because "insurance will pay for it." The big monster is fed, and he grows bigger, needing ever more food. Now, our top ten candidates (with the possible exception of Ron Paul) think the answer to the health care crisis is to put more money into it, feed it, and make it bigger.

John Edwards wants to require us to have two government-paid physicals every year. That's just what we need: make everyone go two more times a year to the already overcrowded clinics and wait an hour and a half beyond our scheduled appointment. I seriously doubt that Edwards has been in a public clinic -- at least without a legal deposition in his hand -- in thirty years.

One more thing. One candidate, maybe Edwards, but it could have been Obama, said that his recommendation was that all Americans get the excellent coverage that he and his fellow lawmakers get. I have a better idea: that he and his fellow lawmakers get the substandard coverage that we do. If Hilary had to go to the same clinics we do, with the same insurance we have, she would not be touting universal health care; she would be demanding what I'm talking about: affordable health care.

There was a time when routine medical care could be covered out of pocket. A night in a hospital room was much cheaper than a night on a luxury liner. That's no longer true because we continue to feed the monster, and I'm afraid that in November, Americans will elect a president and congress that want to solve the problem by giving it more food.