Americans pay $650 billion more for health care than comparable countries...

It is technically $643 billion, the additional amount Americans paid for health care in 2006 compared to the other countries with comparable wealth and health, according to the research article "Why Americans Pay More for Health Care?" in the December 2008 issue of the venerable McKinsey Quarterly. (Ok, probably not as venerable as The Harvard Business Review, but still a good thing to be inserted into your conversation with your interviewers...)

Please don't freak out: this article is actually quite easy to follow and it is written in plain English, so there is no "Huh? WTF are they talking about?" or "Do they know what they themselves are saying?" moment. I promise. In addition, there are a lot of charts. We love charts! And these charts actually say something and make sense. Bonus.

Some quick takeaways:

Countries spend more on health care as they become wealthier.

The main source of this gap of $650 billion? Outpatient care. "Outpatient care is by far the largest and fastest-growing part of it, accounting for $436 billion, or two-thirds of the $650 billion figure. The cost of drugs and the cost of health care administration and insurance (all nonmedical costs incurred by health care payers) account for an additional $98 billion and $91 billion, respectively, in extra spending."

"Today, the US system delivers 65 percent of all care in outpatient contexts, up from 43 percent in 1980."

Although in theory this shift should have cut the cost down, in reality the overall cost went up because of the high utilization rate of outpatient care. However, it is not because we go to see the doctors a lot more often, rather, the average costs per visit has gone up and the number of expensive tests, such as MRIs and CT scans, are performed more frequently.

The root cause of this? Insurance and low out-of-pocket expense.

There is no check in place to guard the price increase. On the contrary, seeing a doctor may be like buying a high-end purse -- if it is expensive, it must be good. And vice versa.

The article concludes thus, "In the United States, the 'average' consumer of health care pays for only 12 percent of its total cost directly out of pocket (down from 47 percent in 1960), as well as for 25 percent of health care insurance premiums, a share that has stayed relatively constant for the last decade. Well-insured patients who bear little, if any, of the cost of their treatment have no incentive to be value-conscious health care consumers."

This sounds familiar but now we have the numbers to back up our suspicions: in order for any health care reform to work and stick, it is important that we carry out the education and cultivation of a new generation of patients that are "value conscious" and treat the burden of health care, even when they do not have to pay for it DIRECTLY, as ultimately their own INDIRECT cross to bear.

"That's so Gay" is NOT so funny! This has nothing to do with sense of humor...

Steven Petrow's post on Huffington today really struck a chord:

"That's so Gay" is Not So Funny

I am so happy and relieved that someone brought this subject up, again. Since Huffington is purportedly the most linked blog site in the world, hopefully more parents and teachers would be reading about this.

I have been extremely bothered by the prevalent usage of this word to refer to anything "ridiculous", "hideous", "tacky," "stupid," "OMG I would not be caught dead in this" amongst the young crowd, and by young, I mean 4th graders -- my son personally encountered this verbal bullying at the bus stop and the perpetrator was a fellow 4th grader.

So what's the big deal? We cannot even make jokes now?

Mr. Petrow wrote:

"According to a recent Gay, Lesbian and Straight Education Network (GLSEN) survey, 'anti-LGBT bullying and harassment remain commonplace in America's schools' and that remarks like 'that's so gay' foster a homophobic environment and worse. The GLSEN findings showed that 75 percent of high school students reported hearing remarks such as 'faggot' or 'dyke' frequently, with nine out of 10 often hearing 'that's so gay' or 'you're so gay' (meaning stupid or worthless)."

When my son was "insulted" with this word, yes, I understand, not for his perceived sexual orientation but as a stand-in word for anything negative in general, I immediately wrote a long letter to the teacher asking her that if we don't nip this in the bud now, how far are we going to let it go?

I am glad that I am not alone in sounding the alarm. Of course, this phenomenon is way beyond the school yard, people use this expression at work places all over the country. Words like this are particularly pernicious exactly because of its seeming harmlessness. "Oh, you are a baby if you cry about it and cannot take the joke." So we learn to shut up and keep quiet.

The increasing popularity of the usage of "Gay" as an insult is indicative of the underlying homophobic mentality permeating in our society, despite decades of working towards acceptance by the "mainstream". This is, the way I read it, part of the backlash against the gains made by gays and lesbian. They have co-opted the word "queer" so that now it conveys pride in self-identification in some specific uses. It is then not too far off to see the co-opting of the word "Gay" as revenge by the not-so-enlightened amongst us: they are trying to turn the previously neutral and PC "label" (for lack of a better word) into a slur. "You took an insult word from us so that we can no longer hurt you with it. Guess what? We are going to turn how you have been identifying yourselves with into a insult equivalent of anything undesirable..."

Clever maneuver by the not-so-tolerant.

What does this say about how we really feel about those who are different from the "norm" deep down, behind the door, if we allow the use of this word on the playground and in the school hallways as part of the litany of insults that our kids can hurl at each other?

Obama is in Da House! Day One: Capping pay for White House employees and banning gifts...

Those who are affected, i.e. those whose salaries are more than 100K a year, are probably not too happy about this, but we are thrilled to hear that the man seeks immediately to rule by example.

"All of you are committed to building a more responsible government... Families are tightening their belts and so should Washington," said President Obama to his staff.

The president also signed new executive orders to implement new ethics rules to ban lobbying by current staff after they leave the administration, including a ban on gifts!

Say that again? I cannot believe this. Amen to that!!

My favorite quote: "The absence of alternatives clears the mind marvelously."

"The absence of alternatives clears the mind marvelously." Henry Kissinger

 

I am sure he said it in a context that was different from what I take this saying to mean.  FWIW, for some reason, it's been haunting me.  Sometimes I see it as pessimistic, sometimes I see it as optimistic, Grin and bear it.  This is what existentialism is distilled down to, at least in my book, "Life sucks, but you've got to deal with it."  When Goethe said, "God is dead," I believe that's what he meant: Regardless whether there is God or not, human beings need to take responsibilities for our actions.  Accountability, and the will to see things through.

 

As I tell my kids on a nearly daily basis: You've got to do what you've got to do. 

I dig "Really? Really??" "Are you serious?!"

I don't understand why there was not more bluhaha around the AIG retreat. For those of you who haven't heard of it, AIG brought all their top executives to St. Regis Resort in Monarch Beach, Calif for a week-long retreat. The $443,000 tab includes $23K for the Spa. Here is the breakdown for a vacation of the lifetime:

(See Washingtonpost.com for the full report)

Washingtonpost.com

Most of the attendees at the convention between Sept. 22 and Sept. 30 stayed in premium "pool view" rooms at the 400-room hotel, with 47-inch LCD TVs and marble bathrooms furnished with a "Deep Roman" bath and shower. The rate: $375 per night.

The group also booked 17 "ocean view" rooms, at $425 each, and one "presidential suite," discounted from its usual $3,200 a night to $1,600.

Another $9,982 was spent on food and drinks at the StoneHill Tavern, the Monarch Bayclub, in-room dining and the lobby lounge; $6,939 on golf; $1,488 at the Vogue Salon; and $1,450 on no-show and cancellation fees.

An invoice dated Oct. 3 said AIG still owed the resort $40,543 in charges after a $402,701 deposit. The itemized bill does not show what executives specifically ordered at the spa and salon, but a look at the hotel's spa menu shows 75-minute "intuitive massages" at $215 a pop (most of the executives spent $210 each for a spa treatment on Sept. 25) and men's and women's haircuts and styles starting at $50 and $75, respectively. Executives also spent $147,302 on banquets at the hotel and $23,380 at the Spa Gaucin, which features three-story waterfalls..."

The kick is, they went on the retreat IMMEDIATELY AFTER receiving the Fed's Bailout package of $85 Billion.

Talk about reinforcing bad behaviours! And I got dirty looks from the storeckerk when I bought my child a lollipop after he threw a tantrum???

I cannot believe that there were not more reports on this. Weren't people outraged? I surely am. I am utterly disgusted. Are people simply tired? Or have we been so thoroughly disgusted that we simply don't want to talk about it any more? This fall has been great for SNL. You cannot make these stories and characters up. Most people weren't alerted of this outrage until they saw the Weekly Update skit on SNL. (Fastforward to the 2:15 mark if you must...)



If I had written a story like AIG and the beyond-comprehension shamelessness in my creative writing class, I would have been criticized for being contrive, buying into the archetype, for catering to cliches. This is real life! In one's wildest creative dream, one would never have been able to conjure up a character such as Sarah Palin. I wonder whether people on SNL should consider voting for Republican this time to make sure that Palin stays in the limelight for four more years. With her in the White House, they can probably get rid of half of their writing staff and simply replay whatever is going on in real life.

I am beyond outraged. I am actually for once, speechless.