"In this sticky web that we're all in, behaving decently is no small task." -- Novelist Stacey D'Erasmo

Saturday, November 29, 2014

Europe -- Are You Kidding?

     Sometimes I hear people make the argument that we here in the United States should do something because so many other developed countries, especially in Europe, are doing it. Social welfare programs. Universal health care programs. Higher minimum wages; stronger unions; longer vacations; more civil political discourse; certain attitudes about sex, drugs, education, homosexuality, military power, immigration.

     I believe the United States does need to reform many of its systems and develop more civil discourse. And I think everyone should have access to a good public education and at least a basic level of medical care . . . and a decent job and decent housing and decent everything else, for that matter.

Europe then
     But, with apologies to my European friends . . . come on, we should never do anything just because the Europeans are doing it. After all, most of our ancestors left Europe, and not because it was a great place to live, with equal opportunity for all. They left because there was little or no economic opportunity, and very little ability to move up in a stratified, petrified class system. Governments were dysfunctional, religions were intolerant; armies were threatening -- and the place was generally a rotten place to live.

     My own grandparents, on my father's side, left the Austra-Hungarian Empire back in the late 1800s. No one knows for sure, but family rumor has it that my grandfather sneaked away just as he was about to be conscripted into an army he wanted no part of. On my mother's side, my ancestors left Ireland, circa 1850, because they had no land, no crops, no job, no prospects -- and they were starving to death.

     And then what happened? Europe brought us World War I, thousands of people dying every day at Verdun and the Marne and a lot of other places. Then the Europeans brought us World War II, costing roughly 60 million lives. Then there was the Cold War, and Northern Ireland, and Bosnia-Herzegovina. And whenever the Europeans weren't arguing, squabbling and fighting amongst themselves, they were setting sail to the Americas or Africa or Asia to bully any other people they could possibly take advantage of.

     We Americans feel a collected guilt about slavery and the slave trade. But who were the biggest slave traders? Not the Americans. It was in this order: The Portuguese, then the British, French, Spanish and Dutch.

     I remember my first trip to Europe, as a college student in 1969, bumming around with a friend of mine. Yes, the trains were good. Everyone says the trains are good in Europe, and they are right. But the bathrooms were totally antiquated. It was hard to get hot water. And do you know what they used for toilet paper over there? Stiff brown paper that was about the same texture as a paper bag from a grocery store. I really don't know what they use now; but I was back to Europe in the 1980s and again in the 1990s, and the toilet paper wasn't much better.
Europe now

     Okay, you say. But the Berlin Wall came down, and the Europeans are so sophisticated, and socially progressive, and we hear that the education system in Finland is so effective and forward-leaning.

     Maybe. But remember, a lot of those countries still have royalty -- kings and queens and princes and such -- including those so-called progressive Scandinavian countries of Norway, Denmark and Sweden. And as for the socially progressive economies that reward employees with so much vacation time? Some of that is true. But first you have to get a job. The unemployment rate in France is 10%. In Ireland it's 12%. In Italy it's 13%; in Spain it's 24%; and in Greece it's 26%!

     As for the educational system in Finland? The population of Finland is 5.4 million people. That's smaller than the state of Wisconsin. Smaller than Maryland or Missouri. How can you compare a system that works for a population of 5.4 million fairly homogenous people with a system that has to process 60 times that many people of all different races, creeds and colors?

     There are a lot of things we could do to improve our public education system, starting with more early education and including longer school days, longer school years, and more emphasis on academics and less emphasis on sports.

     But the idea that we can look to Europe as a model is ridiculous. I'm not saying Europe is bad; I'm saying it is no better than the U.S., and for all its social programs, it is in many ways a backward, conservative place, full of people who are every bit as self-interested and self-centered as we are.

     Europe is a great place to visit. Lots of museums and tourist spots. But I wouldn't want to live there. And I certainly wouldn't recommend using Europe as a model on which to build our own political, educational or social system.

Wednesday, November 26, 2014

The One Thing I'm Thankful For

     I'm not a big fan of Thanksgiving. I don't like watching football on TV. It's usually too cold to do anything outside. And there's something that strikes me as a little weird about a holiday focused entirely on stuffing as much food into our mouths as humanly possible. Plus, I try at all costs to avoid traveling around the Thanksgiving holiday, when flying or driving bring on not just the usual anxieties but outright, full-fledged panic.

     But there's nothing wrong with taking a day to count our blessings, to be thankful for what we have, rather than complaining about what we don't have, or feeling envy for what others might have. And after spending the last year and a half volunteering to help kids at our local community college, I can wrap up all my thank-yous into one big package:  I am thankful that I was born into the American middle class.

     Saturday Night Live and satirists of all stripes have a field day making fun of the middle class -- how bland we are, how boring, how conformist, how white and pasty we are, how earnest we are in our ticky-tacky houses, etc.

     But I volunteer at our local community college, helping mostly underprivileged kids learn how to read and write and analyze and organize and think about things. A few of the students I see are middle-class kids who typically exhibit some kind of mild learning disability. But most of the kids are people of color who live in the poorer sections of our county, and who come from the American underclass. Many originally came from another country, and English is their second language. Some were born here; but their parents speak Spanish or something else at home.

     A few of the students are women in their late 30s or early 40s, who have come back to school to get their degree. They are grandmothers. They live with their daughters and their grandchildren. One of my favorite students is Mary, who writes children's stories for her creative writing class. Her command of grammar is very basic and extremely flawed. Yet she comes up with simple but charming, and often very imaginative, stories based on the exploits of her own grandchildren.

     What strikes me about these students -- whether they're black or white or something in between -- is that they all grew up under challenging circumstances. Probably some of them have suffered discrimination. But the real common denominator is that their parents are poor, or near poor. They were not read to as little children. They did not go to enriching nursery schools. They grew up in apartments, and their backyards were the streets. They went to marginal public schools, and their attendance was sometimes interrupted for one reason for another.

     In short, these students, who range in age from 18 up to about 45, did not benefit from a middle-class upbringing, with good local schools, private music lessons, soccer camp and SAT preparation courses. And yet, their clear ambition is to struggle their way to get a better education, which will lead to a better job, which will eventually help them achieve the much-ridiculed, but also much-sought-after middle-class lifestyle . . . aka the American Dream.

     Maybe there are some "welfare cheats" and "welfare moms" out there who play the system and plan to live on the dole for the rest of their lives. But not these kids. I have enormous respect for my students -- especially (as I remember my own unsuccessful attempts to learn a foreign language) those for whom English is a second, or sometimes third or fourth language. But all these students have hope; they have ambition; and they also have a road ahead of them that I don't think I could have successfully struggled through when I was a young man.

     All of these people are trying hard. Some of them will go on to four-year colleges and careers in business or computers or social services. Some will be disappointed. But all of them deserve our respect, our support and our encouragement. 

     On this Thanksgiving, I give thanks that my road was an easier one, that I was lucky enough to be born into the middle class, and not the underclass. And so, especially now, I wish them the very best.

    

Sunday, November 23, 2014

What Boomers Worry About


     The transition from the working life to the retired life can be difficult and disrupting, so it should come as no surprise that anxieties have blossomed among Baby Boomers concerned about the financial, social and physical challenges of growing older. Those anxieties begin to bud when middle managers realize their gray hair is no longer a mark of distinction, but a liability for the next job interview. And they grow as people suffer diminished physical capability, loss of control over their lives, and perhaps feelings of invisibility and irrelevance.

     Boomers were born during a time of post-war national prosperity. But the fact that there are so many of us has created a competitive world -- a battle for resources that we have waged throughout our lives, from college admissions to landing a job to buying a home, and now to the struggle for resources in retirement as we begin to put financial pressure on Social Security and Medicare.

     Recent surveys by the Center for Secure Retirement, AARP, and other organizations suggest some of the issues that worry middle class Baby Boomers.

     High Anxiety. According to a poll by AARP Baby Boomers are more worried than any other age group about retirement security. Over 70% of Boomers expect that they will have to delay retirement, and half of us fear we will never be able to give up the 9-to-5. The organization used a number of economic factors, from inflation to affordability of health care, to create an anxiety index. People between ages 50 and 64 topped 70% on the index, while younger people (too young and stupid to worry about it?) scored 50% and the 65-plus crowd (who are covered by Social Security and Medicare, and grandfathered into pensions) came in at a relatively contented 46%.

     Young at Any Age. Ironically, most Baby Boomers do not worry too much about how long they're going to live. Surveys suggest that Boomers feel as much as 15 years younger than people the same age a generation ago. Boomers peg "old age" somewhere around 78 or 80, and most Boomers without major health problems assume they're going to live to about 86. And that's a reasonable assumption. The life expectancy of a current 60 year old, according to government statistics, has reached a record 84 years.

     Health Care. Boomers believe that their health is pretty much out of their control. According to the Center for Secure Retirement, 65% of middle-age Americans think their health is mostly determined by their genes, as opposed to 46% who say it's largely controlled by diet and 44% who credit exercise as the key to health. However, we Boomers still do worry about declining health in our advancing years. Nearly four times as many Boomers worry about health more than they worry about finances or outliving their money. Most of us are concerned about escalating health care costs -- at the very time when we are beginning to have increased needs for medical services and costly prescription drugs.

     Money Matters. Yet, Boomers have very mixed emotions about their finances. Despite our worries, few of us have calculated the actual amount of income we will need in retirement, and fewer still have figured out how much savings we need to produce that income. But many Boomers say they already have downsized their lifestyle and curtailed spending so they will have enough money in their sunset years. Many have also come to terms with the prospect of delayed retirement, and say they are willing to either stay in their current jobs longer, or work at least part time in retirement in order to make ends meet.

     Message Delivered. Boomers in general cite a desire for a simpler, less expensive lifestyle. That dovetails nicely with the fact that many do not have enough savings to support their current spending in retirement. The Boomer desire to continue working in some way during retirement also helps. Still, with the mobility of modern life and the fraying of American families, many Boomers wonder who will take care of them when they eventually become old and incapacitated.

     Meanwhile, some 70% of current retirees rely on Social Security for at least half of their income. Yet almost 80% of Boomers worry that the future of Social Security is in jeopardy, and a third believe that in 20 years Social Security as we know it will be a thing of the past.

     So what are you worried about? To me, it seems that among all the different anxieties, one message rings out loud and clear:  Protect Social Security and Medicare . . . on behalf of all of us.


Thursday, November 20, 2014

$185 Worth of Medical Advice

     I had my annual physical the other day. I decided to go to my primary care physician (which my medical group told me would cost $185) rather than a physician's assistant (which would have been free of charge), for two reasons. I went to this doctor last year for the first time, and there were a few little issues that came up, and so I wanted to follow up on them with the same doctor. The other reason? Well, to be blunt, I figured a doctor would know more medicine, and give me a more authoritative checkup.

     The long and short of it is ... I'm fine. I have no idea if the doctor gave me any better service than a PA would have done. Still, I like the idea of developing a relationship with my doctor, however slight, so he knows my body and my history, and therefore is more likely to sense if and when something is "off." I had that kind of relationship with my old doctor, who I'd been seeing for about 20 years. Unfortunately -- and tragically -- my old doctor, who was the same age as me, got an aggressive form of cancer a little less than two years ago and he died within six months.

     So last year I found a new doctor in the same medical group. He's in his early 40s, and looks very young to me, but I have to believe he knows what he's doing.

     Anyway, I'll pass on a couple of insights from my visit (at no charge!). First, I went in looking for a shingles shot. My sister has been pushing this on me for a while. She got the shingles vaccine a couple of years ago. "You know, Dad got shingles before he died," she reminded me. "So I got a shingles shot, and you should get one too." (In case you're wondering, she's my older sister, and so has no reservations about trying to boss me around.)

     But instead, I came out of the doctor's office with a shot for pneumonia. My doctor said I could get the shingles shot, and yes, he did recommend it for people my age. But his enthusiasm for the shingles shot seemed somewhat measured, while he thought the pneumonia shot was more of a must-have. Honestly, he thought my risk profile for either disease is very low. Nevertheless, he said, if you get shingles, it can be painful. But pneumonia can kill you.

     I could have had both vaccines at the same time. But I decided to get the pneumonia shot now (it's a one-time vaccination); and do the shingles shot next year.

     The other thing he told me is that the scholarly literature has suggested that annual physicals do not, in the aggregate, extend our life expectancy. There are two theories. The annual physical approach is based on early detection. The doctor catches something early, and therefore is more likely to be able to cure it, or at least manage it. The problem is that there are many false positives, resulting in a lot of unnecessary medical tests and treatments, which (again in the aggregate) can often cause more harm than good.

     The other theory says you wait until something goes wrong. Then medicine runs it down, and in most cases is able to treat it successfully.

     All that may be true. But here's my story. I had my first colonoscopy at age 51, and the doctor found a precancerous polyp. He removed it, and I went on with my life. If it hadn't been detected, and was left to develop into cancer, I'd probably be dead by now. So I am firmly in the camp of early detection.
   
     The other advice the doctor had for me? He said that all we know about improving and extending our lives can essentially be boiled down to one paragraph. Eat a good diet with plenty of fluids, fruits and vegetables, and get a decent amount of exercise on a regular basis.

     And so with that ... I'm heading to the gym.

Monday, November 17, 2014

A Slice of Boomer Life

     What are you gonna do . . . we all get older. This serving of the Best of Baby Boomer blogs offers a generous helping of advice about how to cope with the perils and pitfalls of aging -- and the opportunities that go with them.

     Aging can be a bummer (do you have trouble driving at night?), but Meryl Baer of Six Decades and Counting prefers to concentrate on the positive aspects of life at a mature age, such as being able to go on vacation whenever you want. Check out her post A Retiree’s Life to get all the details -- which (if I'm interpreting her correctly) allows us to eat all the chocolate cake we want, whenever we want.

     Could that possibly be right?

     On a more realistic note, record numbers of Baby Boomers are retiring, and Rita R. Robison, blogging at The Survive and Thrive Boomer Guide, realizes that many Boomers are business owners who plan to cash out and use the proceeds to fund their retirement. But she says:  Not so fast! More than 80 percent of business owners have no formal transition plan, and, in the end, only about 25 percent of businesses up for sale actually do sell.

     Those odds are likely to become worse as millions of Baby Boomers attempt to sell their businesses over the next decade in what she terms an "exit bubble." Combine the lack of readiness with the historically low success rate for selling a business, and you could be looking at a perfect storm for business owners. So in an attempt to help them out, she enlisted guest author Tensie Homan, a CPA, to offer Five Tips for Selling Your Business.
     
     Next we move on to smaller, more compact matters. According to Amy Blitchok at Modern Senior the recent release of AARP’s tablet, the RealPad, was a bit of a bust. So in her post Great Deals on Tablets for Seniors she offers some recommendations for the best affordable tablets that are perfect for seniors -- and people of any age or skill level -- who want to use a tablet to communicate with their families, share photos and check email.

     Laura Lee, aka the Midlife Crisis Queen, poses more philosophical questions. First of all, in How We Boomers Have Changed with Our Culture and the Music, she contrasts the "pathetically optimistic" tunes of our childhood with the grittier lyrics of more recent times, and wonders if our taste in music has evolved with our worldly wisdom.

     Then (to add insult to injury), she recently walked into a restaurant. The server immediately assumed she was there for the Senior Special, which left a bad taste in her mouth, and made her ponder Do I Really Look Like a Senior Now?

     Finally, on a more serious note, Kathy, at Smart Living, reveals that she is a former smoker in Why I'm a Grateful Quitter. "No I won’t pretend it was ever smart or healthy," she says, "but back when I was a smoker we didn’t think much about it." Yet she admits that every time she coughed she suspected there would be a price to pay.

     Kathy quit over 25 years ago. But her mom wasn't as lucky, and she paid for it with her life. That’s why today Kathy is a strong supporter of the Great American Smokeout and its theme “Quit Together. Win Together.” The smokeout event occurs every year on the third Thursday of November, which this year falls on November 20. As Kathy concludes, "I don’t regret much in my life but I do regret not being able to help my mother quit so we could both have won against this addiction together."

Friday, November 14, 2014

Always Finish What You Start

     On Wednesday it was sunny and in the 60s. Then last night B and I took our dog out for her evening walk . . . and it was snowing! Just the first flurries, but enough to signal that winter is coming.

     There's nothing like curling up with a book on a snowy night. And last night I started reading a new book. B and I always read for a while before we go to sleep, sometimes only for ten minutes, other times for half an hour or more. But we both find that reading a book is absolutely the best way to fall asleep.

      But last night I was having a bit of trouble -- not falling asleep. Something else. Let me explain.  

"What's that white stuff?" asks our fall scarecrow.
     Maybe this seems familiar to you. First, about two weeks ago a friend of mine -- the friend I call Peter -- gave me a book to read. "It's really interesting," he said. "I'd love to know what you think."

     The book is The Burn Palace, a novel by Stephen Dobyns. I'd never heard of this writer before, but he's written a couple of dozen books, so he's not exactly new. The book is a mystery that takes place in Rhode Island, and the problem is: I did not like this book at all. I got through to about page 200 before I thought about giving up on it completely. Then I thought, well, I'm halfway through, so I should finish it. Besides, Peter's going to want to know what I think, and I can't tell him if I don't even know what happens at the end.

     So I plowed on, day after day -- because I find that if you don't like a book it takes a lot longer to read. I felt like I was doing homework the whole time. But I'll be seeing Peter tonight at our monthly poker game, and I know he'll ask me about the book, so I had a deadline.

     I dutifully went back to the book, over and over, reading maybe 20 pages at a time before giving up again. Finally, on Wednesday, I forced myself to finish it. Done! But then, I thought, why do I feel like I have to finish a book if I don't like it? And what am I going to tell Peter (who obviously liked the book)?

     So anyway, last night I joyfully picked up another book. This time I wanted one I would actually like. I grabbed In the Lake of the Woods by Tim O'Brien, which was sitting on my son's bedroom bureau. It has an intriguing cover -- and I thought I'd read something by Tim O'Brien before, and liked it.

     I went into the bathroom, washed up, brushed my teeth, then slipped into bed. I showed the book to B. "Have you ever read this one?" I asked.

At least this one I will enjoy
     "Oh, yeah," she nodded.

     "Is it any good? I need something that will really hold my attention, something I can get lost in."

     "That should work," she replied. "It's a really riveting book."

     "I think I read something by Tim O'Brien before. Something about Vietnam, maybe?"

     "He had that other bestseller," she said. "I don't remember the name."

     I looked at the book cover. "It says he also wrote Going After Cacciato and The Things They Carried."

     "The Things They Carried. I think that was on Vietnam. A big bestseller."

     So I opened the book and started reading. And . . . wait a second, this seems familiar. John Wade and his wife Kathy are on vacation in Lake of the Woods, Minnesota. Wade has just lost the primary election for U. S. senator: "loser by a landslide" at age 41. Then there was a section called "Evidence" and his mother says, "He was always a secretive boy." And by about page 10, I realized I'd read the book before, only a couple of years ago.

     I don't know if that's ever happened to you. But boy, did that make me feel stupid.

     And yet, by now I had started the book. So I have to finish it!

Wednesday, November 12, 2014

Weekend to Remember

     For someone who claims he doesn't travel -- see last month's post  Why I Don't Like to Travel -- I seem to do a lot of traveling. Okay . . . in my defense, I usually don't go very far. My comfort zone is a couple of hundred miles, a three or four hour drive.

     Last weekend we journeyed to Lancaster, Pa. B has some family in the area, including her 98-year-old mother who lives in an assisted living facility. Lancaster, she tells me, has become a destination for many retirees because it has top-notch health facilities, a variety of independent and assisted living options, and a notably caring community.

     We didn't stay with her mother. We stayed in a very nice B & B a few miles outside of town. And I was surprised -- the place was full! Who would go to Lancaster, Pa. in November?

E. J. Bowman House Bed & Breakfast

      The area is a tourist destination for people who go to see the Amish riding in a horse and buggy. We didn't see any Amish on our long weekend, but we did see a few Mennonites (I think of them as Amish-lite). And we also saw a few other attractions. For example, there is a lot of history connected to the area. Lancaster was the capital of the Unites States for exactly one day during the Revolutionary War. It was also the hometown of a U. S. President . . . President James Buchanan, who is never considered among the best of the U. S. Presidents. But still, he was a President.


Home of James Buchanan, U. S President, 1857-61

     There's also a college on the edge of town. Franklin & Marshall is a small liberal arts college that's part of the Centennial Conference, which includes Swarthmore, Haverford, Johns Hopkins, Gettysburg, Bryn Mawr and a few others.


Kind of screams college campus, doesn't it?

    There's an historic downtown area with a theater and an arts hotel and a stadium for a minor league baseball team. I didn't take a photo of the baseball stadium (not very interesting), but I was very impressed with the train station.

One impressive train station ... and I like the bicycles

     An interesting thing, in my book, is how you can be walking along the city streets . . .


Street scene in the city

      . . . and then drive out just a few miles, and you're in the country, with corn fields all around. A corn field probably doesn't seem very exotic to most people. But I never see a corn field where I live. Any undeveloped land around where I live is covered with hills and woods, not farms and fields.


Recently plowed under

     Finally, I have to make one confession. Most people, when you ask them what their favorite store is, say Nordstrom's, or R.E.I., or something like that. My favorite store is the local convenience store. We have 7-11 and AM/PM, and they're both perfectly adequate as far as convenience stores go. But they don't hold a candle to Wa Wa, which you find in New Jersey and around Philadelphia. But even better than Wa Wa is Turkey Hill, and we ran across several of them around Lancaster. And, by the way, regular gas was selling for $2.93 a gallon. Now there's a trip worth making!

My favorite store, esp. when gas is $2.93!!

     

Friday, November 7, 2014

A Surprise in the Mailbox

     Sure, I'm interested in social issues and economic questions. But I'm not particularly interested in politics, because politics represent the advertising and public relations aspects of governing, focusing on deceptive messages, irrational appeals, oppositional research and negative labeling.

     In my opinion the Democrats are terrible. The Republicans are even worse.

     I'm also not particularly enamored with the current state of our economy -- the low wages, the lack of opportunity, the reliance on fossil fuels and other resources that will likely get all used up, but not before fouling our environment, choking our air and super heating the atmosphere.

     Nevertheless, I was very impressed when I went out to my mailbox on election day -- although not for the reason you might think.

     Our mail usually arrives in the afternoon. So on Tuesday, as usual, I took the dog out to our mailbox around 3 p.m. Sometimes the mail has been delivered by 3 p.m., sometimes not. (The dog doesn't care.) The mail hadn't yet arrived on Tuesday.

     Like everyone else, we've been receiving truckfuls of negative political ads in the mail, mostly oversized postcards with draconian messages about candidates who are STEALING MONEY FROM OUR SCHOOLS! (photo of crazed middle-aged white male with dollar bills hanging out of his pockets), politicians UNDER FEDERAL INVESTIGATION!! (black and white photo that looks like a mug shot), candidates with MONEY LAUNDERING MACHINES!!! (photo of $100 bill hanging from a clothesline).

     There are candidates who are GIVING AWAY OUR PARKLAND, who WON'T PROTECT OUR FAMILIES, who have VOTED TO RAISE PROPERTY TAXES, who are AGAINST THE RIGHT TO CHOOSE, who have RAISED THEIR OWN PAY, who are part of the WAR ON WOMEN.

     So anyway, I stopped back at our mailbox on Tuesday evening, as B and I were getting home after voting, and I saw yet another pile of junk mail crammed into our box. Oh jeez, I said to myself. Will these politicians ever stop? For Chrissakes, the election is over!

     I reached in, pulled out the pile of mail, stuck it under my arm, and brought it up to the house where I dumped it on the kitchen table. Wait a second, I thought. I didn't see the familiar dark, black, ghostly warnings of the negative political ads. Instead, the pile looked cheerful and colorful and happy. What's going on?

     So I reached down and spread out the mail on the table. No political ads at all. Not one! Instead I glimpsed green triangles and red splotches and bits of silver. Yes, what we had instead were at least a dozen catalogs featuring . . . Christmas items!

     So, yeah, by Dec. 25 we'll probably be just as sick of Christmas as we were of politics on Nov. 4. But I have to hand it to them. They are efficient! The switchover was timed perfectly. The very day of the election, the changeover from political advertisements to Christmas catalogs was accomplished seamlessly. No overlap. No wasted effort. Our capitalistic democracy in action!


Tuesday, November 4, 2014

Can Medical Care Be Free?

     I'll start with a personal note. I recently made an appointment for my annual checkup and was told that if I wanted to see a physician's assistant, then the checkup would be free -- fully paid for by Medicare -- but if I wanted to have the checkup with my doctor, then it would cost me $185.

     Would my Medicare Advantage plan pay the $185? No. Medicare Advantage only applies when Medicare has already paid its share. If Medicare doesn't pay, then Medicare Advantage doesn't pay. So, if I want a checkup with the doctor, I have to pay $185.

     At first, I was appalled. I thought medical insurers want us to focus on prevention, which is what an annual exam is all about, because prevention costs less than treatment. And my doctor knows me a lot better than a physician's assistant who's never even seen me before. So I feel like I'm trying to do the right thing, yet am being penalized for it (although I do not know if this policy is set by Medicare, or somehow set by my medical group).

     But I recalled a conversation I had with a friend of mine recently. Honestly, I wouldn't want to trade places with him. His wife has Parkinson's and a few other medical issues. He has a family history of heart problems, and has been wearing a pacemaker for several years now.

     Last spring he went into the hospital to have his pacemaker replaced. He was complaining about the bill. He said the original bill came to $135,000 for the procedure. His insurance company (he's not yet on Medicare; he still has medical insurance through work) negotiated the fee down to $70,000. Then the insurance company paid $63,000, or 90 percent.

     So my friend got billed for the $7,000 balance. He refused to pay it. In his view, if the insurance company was only going to pay $63,000, then it should have negotiated a $63,000 price. Why should he be stuck in the middle?

     Now, mind you, my friend could afford to pay $7,000. He's a lawyer. He's not rich, but he makes a good salary (even though, at age 66, he's scaled back his working hours). Anyway, his pay is at least good enough for him to own a second home in Florida and drive an Infinity.

     But I could see, he really didn't think it was fair for him to have to pay $7,000 for his pacemaker. Then he revealed that the hospital is now suing him for the money. And he expects to turn around and sue his insurance company.

     Now, put aside the fact that he's a lawyer and is more familiar with the court system than most of us. He's disputing the bill his way. But I wonder if I was in his position, would I dispute the bill? I'd do it my own way -- probably call them up and plead poverty and try to settle for a lower amount -- but would I be right in trying to get out of paying that $7,000?

     Then I read a story in the NY Times called "Unable to Meet the Deductible or the Doctor." A woman got insurance through the Affordable Care Act, but the policy has a $6,000 deductible. (By comparison, according to a survey by the Kaiser Foundation the average deductible for individual coverage in employer-sponsored plans is $1,217.) She had a brain aneurysm in 2011. Now she's supposed to get a brain scan every year. But according to the report, she skipped the brain scan this year -- because she'd have to pay for it herself, since she's responsible for her first $6,000 of medical bills.

     The idea behind a high-deductible plan is that it protects people from going bankrupt if they get a severe illness. But it leaves them on their own for less-than-catastrophic situations. And in many cases, people will simply skip the care they need, because it costs money. Sometimes they can't afford it at all; sometimes they can afford it but it would cause some hardship; and sometimes they just don't feel like they should have to pay.

     The Times story cites another woman who has a plan with a $1,000 deductible. She avoided going to the doctor for an ear infection, because she'd have to pay for it herself. Another person was "shocked" when they were billed "over $1,000" for an emergency room visit. And the list goes on.

     No one expects doctors and nurses and medical technicians to work for free, do they? And all that machinery costs a lot of money. We're not outraged when we have to pay our rent, or use our own money to buy a car or go to the grocery store -- all expenses that are just as necessary as accessing medical care. So why are we outraged when we have to pay a few hundred, or even a few thousand dollars to save our lives, or extend our lives, or alleviate excruciating pain?

     One problem with medical bills is that they are so arbitrary, so random, so completely out of our control . . . and so ridiculously high that they seem unreal. It's like funny money.

     I don't know the answer. But I'm not so outraged anymore that I have to pay $185 to see my doctor. I just hope he doesn't find anything wrong with me . . . I'm not sure I can afford that!

Saturday, November 1, 2014

Remember Him?

     His name was William Henry Pratt. He was born in London, the ninth child of a well-off English family. He went to local schools and attended King's College London, studying to go into the consular service like his older brothers, who all became distinguished members of the British foreign service.

     But William was the black sheep of the family. He was bowlegged, and stuttered as a child, and had a lisp. He dropped out of school and went to work as a farm laborer. Then at age 20, he up and left for Canada.

     Sometime around then he caught the acting bug, and he appeared in several stage shows around Canada. He made his way to Hollywood where he found work acting in silent films and film serials. But the movie business was pretty tough, even back then in the 1920s, and he had to support himself by digging ditches and unloading trucks.

     Around the time he landed in California he changed his name -- in part to seem more exotic, and in part to protect the reputation of his family back in England. He had, after all, become an actor. Nobody knows where his new name came from -- perhaps from a novel with a character called the Prince of Karlova. The actor himself claimed his stage name was actually a family name from one of his ancestors who hailed from Eastern Europe. But his only daughter didn't believe it.

     He slowly built up a reputation as a competent actor, specializing in playing the villain in his early movies (he made well over a hundred films in all). He appeared in two hit films of the time: a 1930 prison drama called The Criminal Code, and a 1931 movie Five Star Final, in which he played an unethical newspaper reporter.

     But it was another 1931 film, based on an old novel by Mary Shelley, that made him famous. The mad scientist was played by fellow English actor Colin Clive. The hunchback assistant was portrayed by American actor Dwight Frye (who was also Renfield in Dracula). And the monster himself was played by William H. Pratt, better known as Boris Karloff, who wore a bulky costume with four-inch platform boots, and plenty of makeup.
     
     Boris Karloff reprised his role in Bride of Frankenstein and Son of Frankenstein, and also appeared in different roles for House of Frankenstein and the 1958 version Frankenstein 1970.   

    Karloff appeared in other movies as well -- Scarface, The Lost Patrol, The Raven, The Body Snatcher, The Tower of London. And in the 1960s he narrated a TV special of The Grinch Who Stole Christmas. But he remained best known for his horror films and particularly for his role in Frankenstein.

     Karloff was famous for playing sinister characters in the movies, but in real life he supported many charities, and every year he dressed up as Father Christmas and handed out toys to disabled kids. He was married five times, and had the one daughter by his fourth wife. He spent most of his life in America but never became a citizen. He returned to England in his final years and remained a British subject up until his death in 1969. He also never officially changed his name. All his life, on legal documents, he would sign his name "William H. Pratt, aka Boris Karloff."

     Boris Karloff followed in a rich Hollywood tradition started by Lon Chaney, who gained fame in 1923 as the tortured Quasimodo in The Hunchback of Notre Dame and also played the phantom in Phantom of the Opera. His son, Lon Chaney, Jr., followed in his father's footsteps, playing in The Mummy, The Wolf Man (and also portraying Lennie Small in the 1939 movie version of John Steinbeck's Of Mice and Men).

     Then there was Bela Lugosi, famous for Dracula, who also appeared with Karloff in The Raven and Son of Frankenstein. The horror hall of fame also includes Vincent Price (The Pit and the Pendulum and The House of Usher); Peter Lorre (The Raven and Beast with Five Fingers); Claude Rains (Invisible Man and The Clairvoyant).

     Most of these old films have been updated and remade over the years. And we, in our contemporary movies, have our own monsters -- vampires, zombies and all those computer-generated ogres that crash across the screen. We also have other modern monsters, like Jack Nicholson in The Shining, or Anthony Hopkins as Dr. Hannibal Lector. Or maybe our latest monster is The Ebola Virus.

     But they're not quite the same, are they?

     Happy Halloween!