Adventures in Health Care, Part IV: An Encounter

Just a quick story and some observations/conclusions from my most recent visit to the doctor to check on the progress of the bone implant to try to give me right-side hearing (this is a physical description, not a political one).

As I was exiting the office, I held the door for a young man and his parents following me. The young man was blind, using a cane and relying on his parents for help, as well.

His mother asked me if I was getting a cochlear implant too. I shared my cyborg connection and my story, which included why the cochlear implant was not an option for me (insurance in the United States considers a one-sided cochlear “experimental,” although it’s common practice {and covered} in Europe). We also discussed the costs of hearing aids, which I assume had been his only option prior to the implant. Although they apparently worked okay for him, the costs were prohibitive since he needed new ones frequently.

Mom and Dad noted that insurance does not cover the cost of hearing aids, whichI knew from both Carolyn's and my experience, but even for someone like their son. “How the insurance companies can say his lack of hearing isn’t a medical condition, I just don’t understand,” she said. “It’s not like he can read lips!”

I commiserated, noting, and they agreed, “If for profit insurance companies are in charge of your medical treatment and care, you can be sure of one thing: a patient’s needs are NEVER going to be the top priority.”

While I would not even suggest that a government run, single payer program would be problem free, at least the theoretical priority is patient welfare, not corporate profit. And while government bureaucracies are notoriously inefficient, I’ve found the same to be true with corporate (especially insurance) bureaucracies. By the way, did you know that despite their complaining, health insurance companies have had record profits and are experiencing record stock levels. (See link here or picture below)

My experience with the system can be used to identify one problem that has a pretty obvious solution. Do you know how much I have paid for all the tests, procedures, etc? $0. My only charge will be an “activation fee.” Apparently it costs nothing to implant the device, or even buy the device, just to start it up. (I know there are costs, of course, but all are covered by my socialized medicine plan, aka, Medicare.) And that’s ridiculous. I’m fully covered just because I’ve reached a certain age, no matter my income or assets. I wonder how much money could be saved with, say, a $500 deductible for people whose AGI exceeded a certain amount the year previous, with a sliding scale and perhaps a cap (adjusted for inflation as the years roll by, like social security income and Medicare premiums) for the very affluent.

I understand the philosophical and political objections, but I would rather decisions be made by doctors and even a bungling bureaucracy than a for profit insurance company.

Stay tuned for Part V. Who knew health care was so complicated? Uh, besides almost everyone?

A Skeptic's Definition of Politics

Or is it a cynic’s definition? Or a realist’s? Or maybe just a pragmatist’s?

“Politics is like sausage. The more you know what goes into it, the less you want to eat it.” That is an old, old adage, (and included as one of the shocking, big revelations from a Wikileaked speech by Hillary Clinton to the Wall Street crowd) but one that has certainly retained, if not enhanced, its credibility as the years roll (roil?) on.

Instead of that analogy, however, allow me to offer a skeptic’s definition of politics: Politics is the art (and science) of using power and self-interest to reward friends, punish enemies, ideally with the goal of benefitting your constituents by solving their problems (too often even if they don’t know or think it’s a problem, or at least their problem). However, it cannot be denied that power will always be intrinsically linked to money. To think that electing any candidate to any office anywhere will magically effect a sea change ignores mountains of evidence going back millennia and represents little more than a delusional pipe dream.

We can debate how big the self-interest piece is, and where it fits in both the big and small picture, but it is naïve to fail to recognize its importance. The day of the selfless public servant is long gone, if it ever existed after the Founders (and not even all of them, either). To think anyone works or acts against their own self-interest borders on the absurd. No one who runs for president (of anything) will pursue courses of action that damage his/her personal, economic, or social standing, no matter how much of an outsider or reformer s(he) claims to be.

Please note, this definition fits more than the government sphere; it applies to the workplace, social groups, schools, even families (although good parents at least try to sublimate their interests to those of their children). [See the Berndt Power Theory for more on this.]

I would suggest that the manufactured outrage to those actions (by others) is either politically opportunistic, hypocritical (and hypocrisy in the political arena is a bi-partisan beast with centuries-old roots), disingenuous or even downright dishonest, or any, all of the above, or more. While I am not trying to excuse it, politics is practiced by human beings programmed to protect their self-interests. I don’t see how that system (and it's as true under Putin as it would be under Trump or Clinton) can or will change as long as it’s other human beings trying to make those changes.

If that fits your definition of corrupt, I cannot and will not argue with you. But I will argue that corruption is often in the eye of the beholder and that no candidate or office holder is immune from that charge. Although I have no argument that we deserve better, should demand better, my realistic view of human nature suggests we are unlikely to get better. While your/our agreement or disagreement with the political positions of any office (power) holder does not make him or her either more or less corrupt, it does reinforce the perception you/we already have of that person.

Have the Clinton and Trump Foundations used their wealth and connections to power to benefit themselves and the causes they favor? Have they used their power and influence to attract supporters to their foundations? Have they used their power to attract donors and money and thereby increase their own influence (in other words, more power; should Donald Trump be the next president do you really expect the influence of his foundation to  diminish–or grow)? Of course, because power unused is like a muscle – it atrophies and, perhaps more importantly to its political practitioners, ebbs from the vacuum to someone else who will use it for their own benefit. Power begets power as money begets money. Move along, nothing new here, nothing to see, no surprises.

I would ask that we all recognize that the perception of corruption is directly tied to our perception of a candidate, up to a point, of course. (Dennis Hastert leaps to mind, as does William Jefferson.) Two things to consider. The first thing is the “stink test.” If the same accusations were leveled at someone we liked and supported, would our outrage reach the same level? Not an easy answer, because it’s often hypothetical, so it is easy to emphatically say “Absolutely!” Second, consider the source, always. What does the accuser (or spreader of accusations) have to gain? It is unlikely that gain is solely “justice” or honesty. Like politicians, we act in our own self-interest, and that self-interest colors our perception. That applies to politics of every stripe and on every level.

Did the Clintons use their political influence to build their wealth and power? Of course. Is that corrupt, or just politics the way we practice it in the United States? Are they any different than Rex Sinquefield, the Koch brothers, the Bush family, George Soros, the Kennedys…. It’s a long, long list. What do you think will happen to the IRS audits of Donald Trump should he be elected president? Is the fact that a large percentage of the so-called personal money he has “donated” to his campaign has been used to pay bills submitted by companies that he owns in whole or in part, companies that serviced his campaign, corrupt? Or, if you’re a Trumpeter, just smart business? It’s all in the eye of the beholder.

Do I wish our system was more honorable? Do I wish our office holders were as self-sacrificing as George Washington (while noting that he was possibly one of the richest, if not the richest man in the country by the time his political career ended)? Of course almost all of us want that. But even if the president himself (or herself) is completely “honest” in the strictest sense of the word (Gerald Ford, Jimmy Carter, Ronald Reagan, George H.W. Bush, George W. Bush, Barak Obama were all personally honest as far as we know, IMO), how many of those past presidents have been used or sabotaged by people they trusted? Because, as long as money is flowing, there will be people using their positions to ensure it flows their direction. And that, my friends, like it or not, is the American political system. Whoever wins on November 8 will change that not one iota.