Avoiding a $108,951 Heart Attack

Imagine you have a massive heart attack. Yes, you, a 44 year old high school swimming coach and Ironman competitor, history teacher, father, and all around good guy.

Now imagine you’re rushed to the hospital in the nick of time. They put in four stents and you’re saved. Then you get a bill for $108,951, nearly twice your yearly salary – this after your insurance company already paid $55,840.

(A reasonable bill – for everything – according to industry experts, would have been between $26,985 and $36,800.)

“They’re giving me another heart attack”, you think.

That happened to a guy in Austin, Texas. Until the press got the story. Then the hospital, St. David’s Healthcare, known for exorbitant billing and run by the immense for-profit HCA Healthcare, immediately reduced the charge to … uh….$782.29. Oops!

Such is the state of US healthcare costs today.

Politicians love to argue about universal healthcare. Republicans say it smacks of socialism (it does), which is really communism (well, no), which is one step away from devil worship (I’ll leave that up to you). Democrats say it’s righteous (being righteous, they would know), is embedded in the Declaration of Independence -“life, liberty and the pursuit of happiness” (hey, two out of three ain’t bad), and should be paid for by rich people (anyone worth more than them).

While Obamacare brought 21 million people into the system, it also brought more bills. Covering all those people is one thing; making the system effective and cost-efficient is another.

Some examples: The US has a higher rate of healthcare deaths than comparable countries. US adults have slower access to doctors and nurses. Our use of the ER is nearly twice that of comparable countries. We spent an average of $8233 per person on healthcare in 2010; 33 other developed nations averaged less than half that – $3268. We have a shorter life expectancy than average. We have fewer doctors than other countries.

A recent article by Ryan Cooper inThe Weekoffers some interesting insights.

A frequent argument cites the “fee for service” model for high costs. But studies show that when insurance companies paid some providers a flat fee per patient per year, costs didn’t go down. Another argument is that, because Americans rarely see all their bills, they overuse the system. That, too, was disproven by studies.

However, studies do support two big differences between our system and those of other countries: administrative costs and drug prices.

Any visit to a doctor’s office illustrates administrative costs. Clerks outnumber the doctors. Why? Complying with a maelstrom of rules and regulations required by the government and the many insurance companies. To lower costs most doctors now join groups.

Insurance companies also pressure doctors to see more patients in less time.

So, what was once a reasonably pleasant 20 – 30 minute visit with your family physician is now a 45 to 60 minute ordeal of presenting your insurance information, sitting in a packed waiting room, filling out medical and HIPA forms, and eventually seeing the doctor for – maybe – 10 to 15 minutes.

Ryan’s Solution: cut administration by reducing government regulations and get insurance companies to standardize procedures and rules.

Americans frequently pay roughly twice what other developed countries pay for drugs. One reason, in 2003 Congress prohibited Medicare, the biggest provider in the country, from negotiating with pharmaceutical companies.

Ryan’s Solution: Let Medicare, the biggest buyer in the country, negotiate with pharmaceutical companies, which would lower prices for everyone.

Ryan is just one of many people studying healthcare. Recently, some big names in private enterprise, frustrated at government inaction and incompetence, also produced some solutions:

1) To cut insurance costs, Amazon, Berkshire-Hathaway, and JP Morgan recently announced a joint project to establish their own health system. That’s over a million people. Stock prices of insurance and pharmaceutical companies tumbled.

2) To educate more doctors, New York University announced free – yes, free – tuition for medical students.

3) To cut drug costs, 500 hospitals, including the Mayo Clinic, just formed a not-for-profit drug company, Civica Rx, to negotiate with makers of generic drugs.

While not changing the whole system, a lot of people are certainly sending a message to government, healthcare providers, and insurance companies alike.

Will their solutions heal a clearly ailing US health system? Let’s hope so. They’re certainly a step in the right direction.

And, at least, a start on eliminating that second heart attack.

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The guys who give away bicycles

Steve Oliver is behind the counter of Zummo’s Hardware in Norristown, PA. He’s replacing the bearings on a rusted bicycle wheel. Tools are scattered across a wooden counter nicked and worn from years of service.

Zummo’s Hardware recalls an era when people shopped at downtown stores on a Saturday, kids rode bikes barefoot, horse buggies outnumbered cars, and the Sears Mail-Order Catalogue was the Amazon of the day (actually better – Sear shipped entire prefab houses to people). Zummo’s is a family business, now owned and operated by Joe and J.J. Zummo, and celebrating its 100 anniversary.

I had met Steve in a previous career when he was selling early MacIntosh equipment and I was a computer novice. My first Mac ran out of storage and he introduced me to something he called an “external hard drive”.

“Hey Henry!” he said recently. “Remember that hard drive? A mighty 10 megabytes – top of the line!”

Steve eventually “got a divorce” from the computer business and started an entirely new business: finding and rehabbing shared homes for elders. “It’s being part of the village. We can’t just pay taxes. Wegottaactually do stuff for each other.”

He met Joe Zummo while buying supplies for his housing business, preferring local stores to big box stores. “We have to support the little guys.”

One Saturday, while Steve was at Zummo’s getting supplies, a 13 year old boy brought a bike in for repair. The employees were busy, so Steve fixed it. But the fix didn’t last, so Steve gave the boy a bike his son had grown out of. That got him and Joe talking about bikes and kids, and kids with nothing to do, and kids whose families couldn’t afford bikes. And that’s when Jeanie, Joe’s daughter who taught third grade, told Joe the biggest problem for elementary schools today is attendance.

Thus was born ZUMMOBIKE.com– the idea of giving bikes (“pre-owned and refurbished” ) to kids as a reward for perfect school attendance.

“Her school taught us the business”, says Steve. “Getting and giving away bikes is a business. It doesn’t make any money, but its still a business.”

The mission of Zummobike.com: Get kids to school.

The challenge to kids: “Never miss a class for a year and get a bike, helmet, and lock.”

This June, ten year old Amy Dieng was one of 38 out of 470 kids at Hancock Elementary with perfect attendance. Later Steve learned she had perfect attendance, not just that year, but every year of elementary school – and kindergarten. They gave her a brand new bike, blue with pink and white markings, along with a brand new helmet and lock.

She is shy and holds tightly to her father’s hand as she tells me: “Steve, he teach me how to use pedal and hand brake. I ride it outside with my cousin, around the apartment complex.”

“It made them very happy” says her father.

Also behind the counter is a lanky teenager who is cleaning a donated bike. Steve shows him how to flip it and put it on the counter so it’s easier to work on.

“Bocar comes in every Saturday morning for a few hours. He’s learning how to repair bikes. He’s a good man. Works hard.”

Bocar is Amy’s older brother. Their mom is a Home Aid caregiver. “And Dad’s getting a masters degree from Strayer University in three weeks,” says Steve.

Steve shows me the basement of Zummo’s. It is filled with bikes of all sizes and colors, some kept for parts, some almost new. Floor to ceiling shelves, jammed with new helmets, line both walls. I ask where he gets the bikes.

“All over. There’s a reverend in Somerdale New Jersey who gave us 75 last year.”

Later, an eight year old girl, Remi, tells me about the bike she got from Steve. “Because I was perfect attendance”,  she says, proudly.

“At the time we were so down financially”, says Remi’s Mom. Her husband had moved out and left the family. “With that bike, we were living in a dream world.”

“Remi was a good salesman”, says Steve. She grins as she describes the day she got her bike – and then told Steve about her two sisters, 15 and six.

“I gave them bikes, too.”

How many bikes have they given away?

“About 200 in the three years since we started”, says Steve. That’s around 200 students with perfect school attendance records.

And three guys – Steve, Joe, and JJ – with pretty good giving records.

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Check out my new book, Gods and Heroes

Its full title is Gods and Heroes: myths around the world.  It has cool stories and lots of pictures – a must for any book of mine.

Why a book about myths?  (from the Introduction)  “Myths are the traditional stories of a culture… we can see a reflection of the people who wrote them – what they thought of the world and themselves, how they were different from us, and how they were the same… (and) why might this culture have thought it was important to continue telling this tale, year after year, generation after generation.”

Think of today’s stories: George Washington’s “I cannot tell a lie” about the cherry tree; Lincoln walking miles to return change to a customer; Teddy Roosevelt and the Rough Riders charging up San Juan Hill; even JFK and PT 109. Whether myths or historical facts, they reflect who we are or want to be.

What separates history and myth? Probably time and who’s doing the telling.

My book describes myths and heroes from thousands of years ago in stories that reflect past cultures and, in small ways, tease the cultures of today.

For example, before there was Babe Ruth or Joe DiMaggio, there was Heracles (p. 107), “the most popular hero to come out of Greek mythology”. Somewhat like the Eagles’ 17 game path to the Super Bowl immortality, Heracles was given 12 tasks to accomplish for personal immortality. Instead of demolishing the Cowboys 27-13, though, one of Heracles’ tasks was to clean all the stables and grounds of King Augeas, “who owned the largest animal herds of all of Greece as well as the most poop-filled stables.”

(Did I mention my book was written to entertain and educate middle schoolers? Works, doesn’t it.)

Like Boston’s shock at 2ndstring Nick Foles’ superior passing, which immortalized him in Philadelphia, King Augeas didn’t expect Heracles “to divert a river to do the cleaning for him”, which immortalized Heracles in Greece.

There is the story of Leizu (p. 140), wife of the Yellow Emperor of China. “One afternoon she discovered some cocoons in a mulberry tree.” When one fell into her tea, “the hot water made the cocoon unravel, and she pulled and pulled at the string… to make silk threat and fabric”.

Far-fetched? How long will it take for the more recent story of making thread from a spinning wheel to feel like a myth?

And then there is the Greek god Zeus (p. 285), “god of kings and king of gods…ruling gods and mortals alike with a muscular arm and a fist full of lightning bolts.”

Being a god didn’t make Zeus a good guy, though, because, “while he may be married, Zeus had enough affairs and children to put him at the center of any Greek family tree.”

Today’s parallel? I just read about Eddie Murphy having 5 wives and 10 kids. (Just saying…)

The Romans liked Zeus so much, they copied his myths for their own god, Jupiter.

You’ve heard, I’m sure, of the Achilles’ heel. (p.10) “It’s named after Achilles, a Greek hero from the Trojan War (in which Greek soldiers hid in a large wooden horse statue which they gave to the Trojans and then, at night, climbed out and killed all the Trojans.” Thus the “Trojan Horse” of today.)

Anyway, back to Achilles. “When he was a baby, his mother dipped him in magical water that would make him invincible…except the heel she held him by. He grew up to be one of the greatest warriors of his age, undefeated until he was shot in the heel with a poisoned arrow during the Trojan War.”

And let’s not forget Inanna (p. 115), “the subject of one of the oldest love poems in human history, but it’s a little too risque to repeat here.” (Middle schoolers, remember).

I recommend you get this book, not because it’s my book, because it really isn’t. Well, it is, really, because I bought it the day it came out. On the other hand it isn’t, because I’m not the one who wrote and illustrated it. I can’t draw – a thing – and I sure as heck can’t write 300 pages about anything, especially gods and heroes.

However, I did bounce on my knee the young Briggs who grew up to write and illustrate it.

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“If it’s painful for you, think what it does to us.”

I have heard some versions of that phrase for a number of years now, whenever the subject of child rape comes up, and not just from Catholics. While the Catholic Church is in the spotlight again this week, and has been on and off for decades, maybe even centuries, it isn’t alone.

A few years ago, my old high school sent a letter to alumni admitting to sexual abuse of students. It wasn’t alone. The Chicago School System had child abuse at its schools, as did LA and other cities. To a lessor or greater extent, so did many other schools, none of them Catholic: St. Paul’s, Choate-Rosemary Hall, Exeter, to name a few. Horace Mann in New York had 62 cases. “Me” and “mini-me”, compared to the Catholic Church, of course, but not in terms of the harm: the non-Catholic kid suffered just as much as the kid in CCD or PSR.

In most cases people who love those institutions – from school alumni to lay board members – share the “if it is painful for you, think what it is to us” sentiment with outsiders. And then continue with their lives as though nothing had happened.

Child sexual abuse is bad; knowing about it and doing nothing to stop it is horrific.

My old high school recently admitted to instances of child sexual assault and rape that first occurred over 30 years ago. They spent the following two years investigating the extent of the claims and sending letters dripping with remorse (written by a national PR firm) to alumni and parents. Not once during those two years did they write about a plan for preventing future abuse.

They used some of the same lawyers hired by the Catholic Church in Boston, the subject of the movie “Spotlight”.  And they applied some of the same tactics to those initial victims: delayed responses, threats of brutal cross examination in court, contentious settlement negotiations, invoking statutes of limitations – effectively wearing down the victims until they broke and gave up.

The good news: the school eventually did the right thing. It settled with the 40 victims and is providing them with long-term therapy and support. The better news: they finally have a detailed plan to prevent future abuses, something they should have done 30 years before.

The problem of pedophilia is not limited to the Catholic Church. But, because of its size, because of its centralized authority from Rome to the US, Europe, Africa, South America, Australia, New Zealand, and other countries, and because of its claim of ultimate morality, the Catholic Church is far more hypocritical and sinister.

Every organism, from the tiniest plant to the biggest carnivore, has one over-riding desire: to keep living and to continue the species. Organizations do the same thing.

Which explains some of the thinking behind “If it is painful for you, think what it is to us”. As any Christian will tell you, Christianity doesn’t promote child abuse; it promotes protecting children. “Suffer little children, and forbid them not, to come unto me: for of such is the kingdom of heaven”, said Jesus. Its a sentiment echoed throughout all religions. Accordingly, pedophile priests are aberrations of a superior morality; the Church itself is good, and noble. To preserve the overarching mission, then, instead of purging these priests, Church leaders transferred them to other parishes, sent them for therapy, and/or retired them. What they didn’t do was send them to jail.

At the same time they protected the pedophiles, they fought the victims tooth and nail in the courts. The victims got brutalized again.

Now, imagine a different approach. Imagine all those in power protecting children, instead of the institution. Imagine pedophile priests being culled out, publicly tried and sent jail. Imagine protocols in place for screening and reviewing priests’ behaviors, overseen by lay parishioners.

Imagine parishioners holding their Church accountable and either leaving it or staying and giving donations to other charities until the Church starts protecting children. Imagine parishioners speaking out – loudly – against the pedophile priests and the bishops, archbishops, and cardinals who covered for them. Imagine Pope Francis doing more than talking; imagine him defrocking or excommunicating Church leaders who don’t practice the morality they preach.

Imagine Catholics not having to say – ever again – “If it’s painful for you, think what it does to us”.

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An “Enemy of the American People”

A few days ago, The Boston Globe proposed that, on August 16th, newspaper opinion writers write about Donald Trump’s “Enemy of the American People” description of the media. As I write this column, 200 other papers have decided to join the Globe.

If Trump walked up to a guy in a bar (assuming no Secret Service to protect him) and started calling him an “Enemy of the People”, “dangerous and sick”, a “stain on America”, “fake news”,  “very dishonest” – which he’s called the media – he’d very soon be looking at the world through his belly button. But because he’s the President and he’s insulting reporters, those same reporters take the insults and don’t react. Why? Because it’s their job to report the news, not be part of it. So, except in rare instances, they don’t respond to their President, a man whose priorities are a constant tan, fake hair, junk food, and a nearly constant stream of lies, especially about reporters.

How long would you take that kind of treatment if you were a reporter? Small wonder they keep a running tally of his lies.

The biggest lie, of course, is the one about the media being the “Enemy of the American People”. Unfortunately, it is a lie so “colossal”few would believe that someone “could have the impudence to distort the truthso infamously”. (The quotes are from Hitler’s 1925 book Mein Kampf, in which he outlined his strategy of using The Big Lie against Jews).

Let’s examine Trump’s “Enemy of the American People” claim, just for a bit. That would include Walter Cronkite, who first brought the America people the truth about Viet Nam. That would include the New York Times, which published the Pentagon Papers and exposed the lies the American government told its citizens about Viet Nam. That would include Woodward and Bernstein, who exposed Nixon’s crookedness. That would include the exposure of Wells Fargo for stealing from its customers. That would include reporting on the thousands of children abused by priests of the Catholic Church for decades, including this week’s stories about 70 years of priests hurting kids in Pennsylvania.

Anyone can post “fake news” on the web, as Trump does. Not so real reporters. Real reporters, working for real newspapers, have real rules: facts have to be verified, usually twice; stories are screened by real, professional editors. Newspapers do this so readers can rely on them for the truth. Do they always get it right? No. But unlike Trump and other purveyors of really fake news, newspapers correct even minor misspellings, immediately. Check any major paper and you’ll see notes to that effect at the bottom of articles.

Which is why the media are not Enemies of the American People; they are Allies of the American People.

Hey, Mr. President, want to see some real “Enemies of the American People”?

How about the opiod Crisis? How about our crumbling infrastructure? How about Russia, climate change, economic inequality and the shrinking middle class? How the World Healthcare ranking of American healthcare as 37th in the world and the US Educational System ranking of 24th or below, worldwide? How about local gerrymandering and a federal government that tears children from their parents? How about banks that steal from customers, a health system that ignores 27 million Americans, etc…?

How about attacking those – real – Enemies of the American People, Mr. President? How about doing something to actually help the country instead of lashing out like an angry 12 year old?

I’m not talking about policy here, by the way. Debate over policy is healthy, as American as the flag. Debate over policy is the friend of the American People, not the enemy. That’s how we choose our leaders, and how, when, why and where they should take this country.

Nope, I’m talking about personality, not policy. I’m talking about one personality who uses lies against truth, who deliberately turns Americans against each other and against a world we once led and helped make safe, who is damaging the very soul of this country.

I’m talking about President Donald Trump.

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