An Open Letter to Representative Zoe Lofgren (D - CA 16)

Representative Lofgren -
I understand that you consider health insurance reform an issue near and dear to your heart - I'm sure many Americans share that view.

However, from what I've read of the various bills being tossed back and forth between the Senate and the House, I'm not entirely sure it's being gone about in the right manner. Furthermore; I can't, in good conscience, support a bill that requires a half-box of paper to print and seems to be thoroughly laden with catering to various special interests and contains "privileges" for various districts about the country - city, county, or state level.

And, reforming only coverage (I hesitate to call it "health insurance" - it doesn't follow the same model) isn't the best answer - it's the business model of healthcare itself that needs to be revised, with coverage revision secondary.

You're going to extend coverage to some thirty million currently uncovered Americans - not a bad idea. But, what provision is being made to allow them to have effective coverage in a system that is clearly overburdened as it is? While this may not result in de facto healthcare rationing due to regulation, it's very likely to happen as a matter of course, in response to increased workload and no concurrent increase in available resources.

Where is the money going to come from? We've printed quite enough - the economy is going to take an awful long time to recover (no matter what CBO tries to tell you.) From the taxpayers? That's the last thing we need - let's not place additional burden on the people who can least afford it. On businesses? That's going to eventually come from the taxpayers - where do you think that businesses get their money?

Further, what is being done about the other side of the problem, to wit: any or all of the following:

• People don't have coverage, and go to the ER for a sniffle - because there is no clinic available, and they know they can get the bill met by the taxpayer or written off by the hospital if they can't pay?

• People have coverage, and think that entitles them to head to the ER for minor issues (as someone recently relieved of the burden of giving care to a chronically ill elderly family member, I've seen plenty of people in the ER who really shouldn't have gone.)

• There are no "urgent care" or "ready care" clinics readily availble - which would reduce the load on the ER considerably. Go /there/ for a sniffle, and save the ER for major cases and trauma cases. Patients with minor ailments will be seen more quickly at a neighbourhood clinic, and triage at the ER will be simplified greatly.

And, to throw in another factor - what about billing by the hospitals and such? I had a four-day stay (trauma case) about four and a half years ago, where I was essentially "under observation" in the neurological ward for massive CNS trauma - I shall spare you the details for the moment. That four days in hospital - no surgery; merely observation, board & care, and a morphine drip - was billed at a cost of forty-eight thousand dollars and some change to the coverage plan we had then. While I know that hospital staff are not inexpensive, I have a difficult time believing they cost that much (particularly when the hospital accepted somewhat less than twenty thousand dollars in payment from the coverage plan, and then came after us for further payment - until I referred them back to the coverage plan.) Something seems amiss, there...

So, what do I finally think?

1) It is not merely coverage that needs to be overhauled. There is a significant disparity between what facilities (in particular) charge and what they get paid, so a better negotiation process really needs to happen there. The industry as a whole could probably stand to have its processes revised.

2) The structuring of the healthcare industry could stand a few changes - adding a "ready care/urgent care" clinic for a certain per capital population or for a certain geographical area would have a few net beneficial effects - reduction of healthcare costs (anything involving an Emergency Room gets expensive quickly!) reduction of ER workload (minor cases can go to the clinic, reserving the ER for majors or trauma,) the reduced cost makes it more likely that the bill would get paid (which would reduce costs all around, once it gets properly seen to,) workload would be reduced on private general practitioners (which would be drastically needed!) and the hospitals, private general practitioners, and private specialists could then focus on the people who really do require help (instead of the people who are generally healthy, and require little more than annual physicals.)

3) Improved negotiations between providers and coverers. Reduce the disparity between requested and paid amounts, and reduce the losses on hospitals (so they don't close up) and coverers (so premiums could then drop.)

4) It may be necessary to change the business model of the coverers. A 'corporation' as long been defined as an essentially sociopathic legal entity whose sole and only responsibility has been to the shareholders, and this has been upheld in court. While I don't enjoy that idea in general, for a healthcare facility, provider, or coverer to take such an attitude is definitely detrimental to the general health and well-being of the American public.

Madam Representative, I'm sure you'd like to see this bill pass. I know that President Obama wants to see this bill pass. Further, I know that I would like to see 'effective reform' pass - but I also know that this bill is not 'effective reform'. Truly effective reform will be balanced coverage across the Nation (with no preferential treatment for anyone anywhere,) will have a net positive effect on the people first and the industry second, and won't result in heavily overworked providers or "rationed care" - either in fact or by regulation. Yes, we as Americans do need to quit going in to the doctor or ER so much - but that needs to be done by individual Americans and not by regulation. "Rationing by regulation" will benefit no-one, and "rationing in fact" will likewise benefit no-one.

I have offered up a two-sided solution to the matter to Speaker Pelosi in the past - this may be readily reconciled without so much verbiage to wade through. Either put the entire American citizenship on the plan that you all enjoy, as elected officials; or put the entire American citizenship - including elected officials such as yourself - on MediCare and sort the problems out afterwards. This should also take care of the growing concern over having to assess taxes against "Cadillac healthcare plans."

I have decided to make a response necessary simply because I recieved /no/ response of any sort from Speaker Pelosi, and that shows a lack of concern for the wishes of the body politic - which is who you and your colleagues are supposed to be there to represent. I didn't even get a form letter with a stamped signature at the bottom, or a "boilerplate" email.

Not wanting to talk to your constituents is a mistake - not only does it show a lack of regard for the people who put you in that job, but you'll miss a great deal (many of us are intelligent people, and we see these problems firsthand. You'd be more likely to get a good solution - or a good start on a solution - from polling us than you would from the "experts" you tend to rely on - who breathe air just as rarefied as you yourselves, and are just as out of touch as you and your lot seem to be. Come out of your offices and talk to us and with us, not at us...)

Failing all of the above; should I find you have cast an "Aye" vote on this bill, I shall make it a personal priority to unseat you (and anyone else voting "Aye," for that matter) at this coming mid-term election. Madam Representative, it's time to clean the House. Will you pick up a broom and help us, or be swept away?

Jon D. Kelley
San Jose, CA; Sixteenth District

Something I've just GOT to know...

Could someone tell me, please, just how difficult it is to leave a proper telephone message? I've never found it difficult - and, if you're using an automated calling system, there's NO excuse whatever for not Doing It Right.

To leave a proper telephone message, include the following as a minimum:
- Your name
- The organisation you're calling from (if applicable)
- Who you are calling for
- Why you are calling
- Your callback number
- Date and time you called
- Times you are available to receive calls

Easy, right? I learned this stuff in middle school - if not in grammar school! - and it's served me well over the years.

So, I am forced to wonder. Laziness, or lack of education? Both?

Oh - and if a significant portion of your work duties includes interacting on the telephone with the public, might I suggest you work on thinning your accent? I really don't mind hearing English with an accent (there are even some I find quite enjoyable with certain - granted, usually female - voices!) but if I have to have you say everything twice and I still have to decipher what you're saying on my end, it needs work. I don't care where you're from, I don't care what other languages you speak. I really don't. I just need you to speak intelligible English while you're here, so we can communicate. I do my best to make sure you can understand me when I'm speaking - I merely ask the same courtesy of anyone who is talking to me in return. If this marks me as "hopelessly provincial," so be it. I don't see any reason to change - and if I were in another country, they'd expect the same thing of me. If it can be turned around and still seen as a fair deal, it's a fair deal, right?

Non-Traditional Marriages

With all of the banter going on about gay marriage, why don't we take a few minutes to explore the idea of "non-traditional" marriages much more fully? After all, I would think that allowing homosexual couples to officially marry (a concept with which I have NO trouble at all, to be perfectly honest. I know a few monogamous gay couples that have been together longer than many "straight" couples I've knows - married in everything but name...) should open the door for pretty much any sort of marriage.

And, I'm not particularly religious. Leaving the Bible aside, I view marriage as a socioeconomic arrangement allowing for the mutual support of the adults involved, and for the creation of a stable and nurturing home for any children involved. There's no reason why a simple "one man and one woman" is the only arrangement that will work for those purposes, nor is there any real reason to think so. And, plenty of reason why non-traditional arrangements will work rather better.

Yes, I'm going to throw out some ideas that most would consider "odd." I am also going to make a couple of assumptions:

1) All participants are willing to enter into such arrangements.
2) Sex is /not/ a prerequisite of marriage. It's a nice fringe benefit, but it's not the primary reason one should marry. "Why buy a cow when milk is cheap?" may sound cynical, but there is a large measure of truth in it.
3) The government does /not/ get involved and screw things up. Methinks the principal reason they screw things up now is because they don't want to recreate tax forms and tax code wholesale (which is what really needs to happen - but in order to rid ourselves of the current "progressive" system where people can actually get back /more/ /than/ /they/ /pay/ /in/ at the end of the year. Something amiss there...)

So, let's begin:

- Heterosexual monogamy. This is the so-called "traditional" marriage that the Religious Right want to "preserve the sanctity of" and that Hollyweird has diluted sharply ("Been married nine times; Hell, maybe it's /you/." There's something wrong with someone younger than I am having a half-dozen marriages and divorces behind them. Seems that this is what should be addressed if one wants to "preserve the sanctity of marriage.") One man, one woman - theoretically for life.

- Amoandry (homosexual male marriage. From roots "amor-" for love and "andro-" for man. My own construction - haven't seen it anywhere.) One form of "gay marriage" that people want to get going, and I honestly don't have any trouble with it. Divorce should be just as much of a nuisance as for heterosexual marriages.

- Amogyny (homosexual female marriage. Changed root "gyno-" for woman. Another new word...) See 'amoandry.'

- Polygyny (multiple women.) This need not be a "harem" approach, but that's usually what comes to mind first.

- Polyandry (multiple men.) Reverse of polygyny - one woman, many men.

- Polyamory. This is multiple men and multiple women in pretty much any combination.

The three "poly-" marriages would have all partners on an equal footing, with perhaps the eldest partner having any "veto power" on group decisions or "tiebreaker" status, if there is an even number of partners.

And now, the really odd situation:

- "Line Marriage." An example of this can be found in Heinlein's _The Moon is a Harsh Mistress_. The typical "line" started with a couple (who become the "senior couple" or "patriarch and matriarch,") and then individuals can "marry into" the line at intervals. Individuals would be allowed to "marry in" at fairly regular intervals, and the gender would typically alternate (although exceptions could be made for logistical reasons, addition of a particular desired trait, trade, or skillset, "going off to war," or suchlike - usually at the discretion of the patriarch and matriarch.) The interesting bit about this would be that the marriage itself would /never/ dissolve due to the deaths of the members, since new members are always on the way in. This would require a contract of sorts to guide the successive members (enforceable by various means,) and the "line" could end up with couples who pair off regularly - again, the idea here is mutual support of the adults and a stable and nurturing home for the children. Considering a line could be allowed to continue for a couple of centuries, and you can see just how stable it could truly be!

The advantage to polyandry, polygyny, polyamory, and line marriage (for the adults) is quite simple - there are going to be a large number of adults avaialable to help with child-rearing. The adults are going to have various skills and various advantages - while someone may not be "baby people," someone else is likely to be. They can handle the child as a baby - when the child gets older and can now be taught complex concepts, this is probably when the person who isn't "baby people" will come to the fore. Therefore, most (if not all) stages of childhood and adolescence would be covered by the person(s) most capable of dealing with the children at that stage in their lives.

Also, an oddity of line marriages would be that the children could "marry back into" the line. Since people from outside the marriage would enter into the line at various intervals, the gene pool could be kept varied - and minimal reinforcable defects brought about - while allowing children to have the continued support of the people they know, only the children are now adults (and the family is still a known quantity to them.)

So, what's the problem here? Primarily twofold:

1) The Religious Right, and their "one man and one woman" rubbish. Yes, it's rubbish - there are plenty of different approaches to raising children effectively, and being able to pool numerous adults and their energy would be greatly effective. I'm sure we've all heard that "it takes a village to raise a child," no? Well, let's put the village in a large home! We used to have the "extended family" living within easy range of each other, until high-speed travel became first a reality, then commonplace - and now related adults are scattered from Hell to breakfast and can't really support each other anymore. My family is /literally/ spread from coast-to-coast, and that makes things difficult. Why not have several adults near to hand in support of each other?

2) Government. More specifically - how are they going to tax polyamorous marriages under the current "progressive" system? That's an easy one - they can't, and they're not. If they were smart, they'd go to something like a "consumption tax" or a "national retail sales tax" (I'll go into that idea in a future posting,) eliminate the entire progressive system (I'll go into the reasons for that as well, when I go into taxation,) and that would take care of the problem. Sure, it would lose the government some revenue - but that can be made up for by simply reducing the number of people in "civil service" (most of which is a sinecure for the incompetent anyhow,) paying elected representatives less (or nothing at all,) eliminating elected retirement and medical coverage (or put them on Medicare - and eliminate retirement entirely,) and the like. Hell, we'd be able to disband the IRS almost entirely once the forms and such go away - since it would be far simpler to administer the NRST than FITW anyhow! THAT should result in a significant savings...

This is a topic that should really be discussed. The rules for comments:

1) Leave out any religious or governmental intonations - they have no real bearing. Government can catch up with the times, and the churches need to understand that they're not necessary to encouraging "moral" behaviour in the populace. I'm looking more for practical discussion here.

2) Practical advantages and disadvantages. It's probably about time for society to swing back over to the idea of an "extended family" like we had in the late 19th and early 20th centuries. There were many benefits to the "extended family" - primarily in logistical and personal support - and with nuclear family units being as far-flung as they are (mine, for instance, is scattered from coast to coast!) we've lost the mutual support of the extended family. Polyamory and line marriage in particular would offer a great advantage - considering the support we've lost, some of it should be regained. The intimacy of an extended marriage can also help - while "meddling relatives" can be intolerable after a bit (because they're not intimates,) co-spouses can be both intimate and mutually supportive.

3) Bear in mind the primary socioeconomic reasons for marriage - the support, education, and rearing of children; provision of a stable home to encourage children; and mutual support for the adults involved. "Mutual support" doesn't necessarily mean "sex" - it simply means that there are more parents available for the children than the normal issue of two. If one of the parents should fall ill, another one can take care of them while the remainder see to the children and the household. Also, having a larger number of parents available means a more complementary skillset, and therefore a more effective teaching environment for the children.

Discuss.

Sociopolitical classification

I seem to have been asked this a fair bit, and I figure I should just put an answer up somewhere where I can point to it - vice having to go through it all at irregular (yet irritatingly frequent!) intervals.

Granted, anyone who pays attention to what I say all the time should be able to suss this out on their own (I have what many view as an irritating tendency to say pretty much what I'm thinking at any given time, unless you just do not need to know) but I guess that's not enough.

Politically, I believe government:
- Should be small. The smaller, the better. It should be just enough to administer the needs of the body politic as a whole, to protect the body politic (as a whole!) and to carry on international congress with the interests of the body politic in mind.
- Should be just large enough to provide truly essential sociopolitical services - infrastructure, public safety, public well-being, and the like. Current service can - and damned well should be - trimmed mightily (as should "civil service" personnel. Granted, there's not much service, and the ones I've dealt with seem to be rarely civil...)
- Should only take what they need to function. There's no particular reason that the total tax bite, at ALL levels, should not exceed ten percent of median income. Yep - including vehicle registration, sales taxes, property taxes, ...
- Should only be allowed to spend the money they can generate through a minimal tax bite. "Deficit spending" is essentially illegal for a private citizen, why should it be legal for governments?
- Should neither pay their elected representatives, nor should they be considered as 'full-time' employ. "Public service" should be precisely that. No retirement, either. No special plans for healtcare and the like. And, you can travel commercial with the rest of us plebes.
- Should be responsible for its actions. "Legislative Immunity" is overused. You want to declare war? You get right out front with everyone else (at a rank not higher than, say, corporal - unless you have prior service and are willing to lead from the front.) You espouse a measure that causes trouble for us? Get ready to be prosecuted for it. So much stupidity comes out of Washington because they can't be held responsible for it. Let legislative immunity stand internationally - but domestically, you can get clobbered. Kinda like diplomatic immunity, but reversed.

Socially? I look for a return of the Social Contract (the unwritten rules of "polite society") to replace the onerous system of laws we have now. Then, wholesale redaction of the laws. There's no reason that the entire body of law to which a person is subject shouldn't fit into a small-to-middlin' paperback book.

Economically? This may sound counter-intuitive, but the basic system should be capitalist with just a bit of socialism mixed in. "Socialism," you say! "That's awful and un-American!"

Not so. No less august a personage than Thomas Paine advocated limited socialism in a capitalist system when he wrote _Common_ _Sense_. The "limited socialism" I advocate is essentially the same as his - pensions for the aged and disabled. Limit payouts to those who actually contributed and/or are citizens (after redaction or total rescinsion of the "anchor baby" laws,) and we can keep it under control rather handily.

Given the current climate of the industry (the industry itself and the litigious nature of the populace,) and MediCare isn't a bad idea, either. Yes, medical industry reform needs to happen - but, as Congress is going about it, I don't expect it to be useful. I know I can get verbose at times, but even I would have a hard time putting out a 1,900-page document on a single subject!

Unemployment? OK, in a limited sense. Social Welfare? Ditto. No-one should stay on either programme for more than a year without some exceptional circumstances being involved. And, I've got my ideas for reform on the latter, if we're going to keep it

Discuss.

Shot at & missed and shit at & hit...

(I never promised this would always be a "work-safe" blog...)

Pthargh. Just when you think you've got enough on your plate, someone just has to toss something else on. As I've heard before; "I know God doesn't give me more than He thinks I can handle, but I sometimes wish He didn't trust me so much."

Case in point:

For the last eight years or so, I've been taking care of my mother-in-law (those of you who know me personally already know how I feel about that.) I've been doing this without help from pretty much anyone (save my wife - she's been wonderful about the whole thing!) and for not even thanks from anyone else (my brother-in-law wouldn't even acknowledge that I was doing much of anything for the first five or six years - by then it was too little, too late - and I spend most of my time being bitched at by my mother-in-law.)

I've probably been doing the job too well - logistics, medical decisions, and all - according to her pulmonologist and cardiologist, I've added something like five years to her life (and I was told this a couple of years ago.)

What problems have I been trying to manage? Let's see:
- End-stage emphysema
- Asthma
- Chronic Obstructive Pulmonary Disorder (COPD)
- Obstructive Sleep Apnea (OSA)
- Hiatal Hernia
- Antral Gastritis, Severe
- Gastric Ulcer, Healed
- Osteoporosis
- Urinary Incontinence
- Irritable Bowel Syndrome (IBS)
- Congestive Heart Failure (CHF)
- Atrial Fibrillation (a. fib)
- And more that I can't remember offhand and some that I can hardly pronounce or spell easily.

This takes up, typically, between thirty and sixty hours a week of my time. Most of it is spent in logistics and organisation (with my own CRS from a fairly recent brain trauma, this means that I must write everything down. The number of notepads I go through is amazing...) Thirty to sixty hours, naturally, does not include trips to the ER (I just took her in again on 07OCT - I thought it was a cardiac event, but it was bilateral pneumonia. Again.)

I have a 1" ring binder that I carry with me whenever I have to take her to a doctor's appointment. I have a pair of 4" ring binders on the shelf in my home office for the detailed records - the 1" binder is merely a summation and ready reference. It also contains the current precis that I maintain for trips to the ER - instead of answering all of the questions, I simply hand them a copy of the precis for their chart and call it done - I can always print another one should I need it.

The precis? That's the short-short form - all of her medications (well over a dozen, plus dosing strength and interval, why prescribed, and by whom,) her extant medical conditions (plenty of those,) copies of her insurance cards (they can then scan them at will,) hospitalisation history, surgical history, and a list of physicians and emergency contact information. I've been told I maintain these records quite well - but that's as much for my own benefit (recall the CRS I mentioned? CRS = Can't Remember Shit. I've been hit in the head entirely too many times in this lifetime, I've long since stopped counting concussions...) as theirs. Drug allergies and contraindications are atop and down bottom of every page in red as well.

My wife has expressed her appreciation for what I do (and she doesn't mind that I'm rather dispassionate about it. If I got emotionally invested, I'd have gotten exhausted much sooner than I have...) Our boys appreciate all of the work I do.

But, I'm doing what is essentially my brother-in-law's job, and I don't get a "Hi" or "Go to Hell" or anything for the first five or six years. Wha?

She recently stayed out with them - only because we (my wife and I) had to put them on the spot for it. She stayed out there for seven months, and saw a doctor (cardiopulmonologist) three times. Out here, it's about every six weeks (if not more) - and that's just for one specialist! We also see the gastroenterologist roughly quarterly, and the cardiologist semi-annually. The podiatrist (yep - she has feet trouble) sees her annually. The urologist roughly semi-annually as well.

And I have a very good working relationship with these doctors. I've had to remind their office staff that I'm not an MD in my own right (I've just associated with them entirely too much, and I speak the language well enough to leave an RN in the dust once I get going,) I'm just a man with a lot of practical experience.

After she came back from visiting her son for seven months, it took me two months to undo everything he'd done (and screwed up...) and she was immediately ill on arrival. Bugger.

My wife and I were talking to her, and we figured out why we had to deal with her being ill - again! - instead of Mike. Why? Because she was afraid to get sick out there - primarily because of his wife. She knows that I may get annoyed with her for getting herself sick again (which is often the literal truth - if she'd listen to me, she wouldn't get so damned sick all the time...) but I'll still see to it and get her taken care of. I'll still sit the twelve-hour ER vigil until she gets admitted. I'll still talk to the doctors and nurses down in ER to get everything to happen.

I may be tired of it, and hate every damned minute of it, but I still do it.

OK, this blog post is probably the most vitriol I'll express in a while. But, dammit, I've needed to do this. It's either this, or I go back to two packs of Luckies a day...

So, now, here's the question. Or "the crux of the biscuit," to borrow from Frank Zappa:

- Does anyone out there consider it wrong that I've finally given up on doing this for anything altruistic, and being about to demand getting paid for what I've been doing?

Mike didn't want to help before because I "wasn't working full time" (because I was spending all of my time taking care of his mother.) I was indeed working full time - I'm pretty much "on call" all 168 hours of every week! I'm just not getting paid for it, so I can't help pay the bills.

I don't want money from my wife - we can't spare it anyhow (we're getting clobbered with medical bills of our own, plus all of the electric for keeping the MIL's medical gear running, plus the fuel for running her about.) I don't want the MIL's money - she's got to fork over enough as it is for her medical, insurance, and upkeep. I want Mike's money - mainly because he's done fuck-all to help so far. Five hundred a month for the past eight years - as back pay - plus five hundred a month ongoing isn't so bad. Considering how many people he'd have to hire to replace me in everything I do, he's getting off awfully light! Although, that $48k up-front payout for back pay is going to smart - but he can live without goodies for a bit (if he's so damned broke, why does he have a 50" Plasma screen in his living room, while we don't even have a TV in ours? Why does he have two relatively new vehicles, while my wife and I share one? Hmm... Sounds like someone's been pissing away money of late - he and his wife both work, their cost of living is less than half of ours, but they never have any damned money...)

So, it's a question for all of you. Am I out of line here? Am I being needlessly mercenary? Or, perhaps, am I not wanting enough? If you've an opinion, I'd love to hear it! If you've got questions about what I spend most of my time doing, I'll do what I can to answer them.

JDK

"Universal Health Care" - Pelosi

Figuring that someone needed to say something reasonably coherent (and, for me, not terribly wordy...) about the whole "universal healthcare" debacle, I've just sent this message to Speaker of the House Nancy Pelosi.

Will it help? Probably not. But, taking the effort and having it fail is certainly better than not taking any effort at all. I'll probably write something similar to President Obama, and I'll put that up here as well.

----- SNIP -----

Speaker Pelosi -
I've been hearing much in the news of late about the "universal healthcare bill" being tossed around in committee, and I'd like to take a moment to weigh in with the comments of a constituent:

1) I find it worrisome that not only is the wretched thing some 1100 pages long, but everyone seems to be in a hurry to pass this thing. Has anyone actually read it all the way through? If not, why are we trying to accelerate a vote on it? How can anyone, in good conscience, vote on something they haven't even read, much less understand?

2) Why are so many pages needed to describe what needs to be done? I'm writing technical books that are considerably shorter than that, and I've got engineering texts that go into much greater detail on subjects in fewer pages - and give a better understanding of the topic at hand (I must admit, I've not even read the thing yet - legislative language tends to be a cure for insomnia for me. However, this sort of thing is what you and your colleagues are paid to do - so you should be able to read it, and you should be provided with the opportunity to do so.)

3) I've also been given to understand that there is to be no tort reform in this bill. Pity that - tort reform would be one of the single greatest things that could be done to bring medical costs down overall! Raise the bar for a malpractise suit to proceed (have a panel akin to a Grand Jury that hears the initial merits of the case, and decides whether or not true malpractise actually occurred, for instance;) and the cost of malpractise insurance should drop sharply. Considering what a malpractise policy typically goes for, this would be HUGE.

4) Streamlining the FDA approval process for new drugs (or - and possibly more importantly - the manufacture of ALREADY ESTABLISHED generic versions of drugs on the market) would work wonders for bringing the costs of prescriptions down. I'm on several due to a massive physical trauma I sustained in NOV2005, and they're expensive even with insurance (seeing the "Your Insurance Saved You:" line on the receipt worries me greatly... Most of this stuff is second-tier or third-tier on the schedule for our insurance plan.) Pharmaceutical companies seem to be willing to work with patients if asked. Medicare recipients can get supplemental coverage (through AARP) for a reasonable cost to bring their prescription costs down to effectively nothing out-of-pocket at the pharmacy. If the FDA simplifies their approval process for generics (simply making the manufacturer hold to quality materials and proper manufacturing processes, instead of having to do pretty much the entire process over again,) then MOST OF US would be able to get our prescriptions covered fully or nearly fully by insurance.

5) Make it easier for service providers to deal with insurance companies, and vice versa. Perhaps have the fixed "Medicare negotiated rate" paid out by any insurance company - this should effectively eliminate overbilling as a negotiation tool with individual insurance companies, and should help to get more providers "in network" for various insured persons using an employer's plan.

6) I've also read in the news how some of your colleagues are considering fining people for NOT carrying insurance under the new plan. I'm not so certain this is a good idea - allow me to modify it slightly:
- There are people who don't carry health insurance in general, paying out of pocket (OOP) for their physical every year or so instead. Why? Because they're reasonably healthy, and paying OOP for the annual (or so) checkup is cheaper than carrying a regular healthcare plan.
- Many of these people have a catastrophic medical coverage plan ("cat coverage",) which covers them in the event of a massive trauma or illness.
- There are also people who, I am sure, WILL NOT BE ABLE TO AFFORD any insurance plan. I'm sure you've heard the phrase "working poor?" There are more of them than you probably think. If they can't afford coverage, how will they afford to pay the fine for not having it?

Offer a "cat coverage" plan for the healthy, since that's really all they need.

For the "uninsured" who end up going to the ER at a County hospital for even a mild case of the sniffles, perhaps having "neighbourhood clinics" for that sort of thing will bring the ultimate costs down, reduce the billable expense, and perhaps enable low-income people to be able to actually pay AT LEAST SOME of their billable expenses, or carry coverage that can cost less due to the availability of a clinic? The clinic may be located near an ER - anyone who gets triaged as "non-critical" would then be sent to the clinic, rather than treated in the ER. This would also free up ER resources - having been a trauma case a few times myself, and being a caretaker for an end-stage emphysema patient (my mother-in-law,) this would be a good thing for me. I see people in the ER that I would like to honestly check for malingering, myself.

I place myself at your disposal for further discussion. However, I feel that further discussion IS necessary - with whomever, but preferably with constituents who actually have to DEAL with this sort of thing - before action be taken. Rushing this sort of thing through committee, through voting, and for the President's signature can not possibly be a good idea.

However, if you and your colleages are in such an all-fired hurry to pass this, please allow me to offer a couple of options:

1) ALL CITIZENS go on Medicare. Yep - including you and your colleages. That should handle any perceived disparities in the system (and probably get Medicare sorted rather quickly to boot.)

2) ALL CITIZENS go on whatever plan you have. It must be good - I'm sure Senator Ted Kennedy never even saw a bill for his medical treatment before he expired (I had to fight to get a bill dismissed as "Paid By Insurance" after my trauma four years ago. Not fun to do. Took only two months.)

Either one should put everyone on an equal footing and make access to healthcare more "universal" than it is now. I'm sure most of American would prefer the second option - especially those of us who are tired of fighting with insurance companies.

I certainly shan't argue that something does need to be done. However, it should NOT be done in a hurry, it should NOT be made overly complex, and it SHOULD be carefully thought-out and discussed out in the open - and made relatively equal for EVERYONE. A line from Orwell comes to mind whenever I see a news blurb on this: "All animals are created equal, but some animals are more equal than others."

Shaving...

I got tired of the King Gillette model - which, with my beard, costs a good deal of money.

"My beard?" Yeah. I can't use an electric - it would hurt less to get my face waxed, or even pluck it clean with a pair of tweezers one whisker at a time. So, that's out (tweezers are cheaper than an electric.) I could probably scrub pots with my chin, if I thought I needed to (and if I needed something more aggressive than Scotch-Brite or Brillo pads...)

I used to use a cartridge blade razor - but those cartridges are spendy. And, I can only do about a one-inch pass before I've clogged the blades and have to clean them out (usually with a toothbrush.) Yes, I shave in hot water, and I try to soften things up first.

I got to pillaging around looking for something else, and managed to find a straight razor handle that took a replacable blade. In fact, it takes a half of a blade - you take a conventional double-edged safety razor blade, snap it in half, and insert one half into a slide-out carrier. Change the blade by sliding out the carrier and using the other half of the blade.

Seven bucks for the razor, and it came with a box of ten blades (total of twenty, once you snap them in half.)

Now, I'd used a Gillette Mach 3 - and only shaved on Fridays, weddings, funerals, and court. Considering I could only use a cartridge about twice before it was shot, and throwing away a cartridge for that razor amounts to throwing away about four dollars, it was getting old rather quickly (I got the Mach 3 as a sample - just as I did the Sensor Excel, and a couple of razors before it.) I hadn't used a straight razor in a number of years, so it took a little bit of practise - mainly to avoid gouging myself.

But, I've noticed something: shaving has become less of "an onerous task" and more "something I enjoy." I don't shave every day, but I now shave on Mondays and Fridays - plus weddings, court, and funerals.

Why? There are a couple of things I can think of:

1) While it did take some practise (a couple weeks' worth) to get back into using the thing, I find it easier to use than a cartridge razor. Hell, I can clear-cut a full beard with a straight, if I feel like it! Yeah, I sometimes snag moles and blemishes, but that can be handled.

2) I don't get shaving bumps anywhere near as badly with the straight than I did with the Mach 3. The Derby blades I'd gotten with the straight were OK, but the Lord blades I'd bought to replace it (stainless ground in Egypt) are much better! The Middle East and Northern Africa really understand blades - almost as well as the Japanese.

3) It's a return to an old-fashioned, purely physical skill. That, more than anything else, is probably why I enjoy it so much.

You see, when I was a kid in Indiana, one of the greatest joys I ever had was learning yet another purely physical skill. Little involvement of the brain - it was just there in a supervisory role, and could pop off for lunch if it wanted to without interfering with what was going on, most times. Yah, some things it had to stay around to watch - but it could think about other things (usually several other things) while it was watching what the body was doing. This is what I mean by "purely physical." Sharpening a knife is a purely physical skill. Whittling is, most times, a physical skill. Riding a bicycle, roller skating, and the like are all physical skills.

And shaving, using a single bare blade, is a physical skill. And, using the single bare blade is more comfortable all around than using a cartridge blade, believe me! I'd honestly suggest that any man who doesn't have palsy at least try a straight razor - what you find out may surprise you!

I'll probably eventually assemble a "real" straight razor kit - good hollow-ground Solingen blade perhaps, strop, brush, shave cup, and the like - but this will work for the moment (and it got me set up to save a bunch of money on shaving for an initial outlay of about ten bucks.) I get one shave out of a half-blade, but I don't throw them away (they're stainless, they go in the cannister for recycled stainless steel...) and they're only about seven cents a shave anyhow. I pay half as much for fifty double-edge blades (of better quality!) than I did for four cartridges.

And, I don't dread shaving anymore. Sounds pretty win-win to me!

I'll have to see what other skills I can renew that are considered "old-fashioned." I can already navigate effectively using a map and compass (on-road or off,) and resolve my position closer than can be done with a GPS device - typical CEP (Circular Error Probable) with a GPS is something around fifteen metres, while I can usually nail myself down to within a half-metre. All by knowing how to read a variety of maps, being able to use a compass, and knowing the length of my pace... Map reading is becoming a lost art - but it's bloody useful! The batteries in a GPS can go flat on you. In your head? Not so much. And, a compass doesn't use batteries in the first place!