Frank: ahhhh...but did you really?
MS CGS: Then there's "Tom, Tom, Piper's son, Stole a pig an' away he run; pig was eat, Tom was beat, Tom went runnin' down the street." (secret Mason-esque code for the potential perils of tracking the Holy Grail) Finally, the esoteric revealed!
Frank: Pig was yummy tho..........
Me: I had totally missed the secret society scenario,the code though may take us as far back as Thomas a Beckett Archbishop of Canterbury from 1162 until his death in 1170.
Me: Now all we need is the secret ring.
Frank: I got one, but can't tell you or let you see it....it's a secret :-|
Me: The truth is that his real name was Gilbert Beket Jr. it must be some linkage to the Thomasine conversion of 1169 that caused Henry II to kill him the following year, and thus he became Saint Thomas to both the Catholics and the Protestants.
Frank: My ring has a video of that.....oops....shhhhh.
Me: Now if I can just tie this all into String Theory by adding a couple of more dimensions, we've got that little trinket from Stockholm sewn up.
MS CGS: Do you suppose Disney's "Thomasina," the cat heroine (re: the divine feminine) is Gilbert reincarnated? Her worst hairball was a visage not of Christ, but of her nemesis, Henry II's rat-fink advisor. She gagged when she spied the secret decoder ring in her daily ration of Cracker Jack.
Me: The screenplay was written by Robert Westerby and Paul Gallico and was based upon Gallico's 1957 novel Thomasina, the Cat Who Thought She Was God. ...
Me: What more proof could we possibly need, it also explains why Frank keeps watching that secret decoder thingy, he's such a cat lover.
MS CGS: It's the Fisherman's Ring. Tom-Gilbert is the Pope!
Frank: Da*n Cats.....watch my decoder for the cat's 9th life.....
Discovery
When I read what I have stretched out before you, I must admit, my blood ran cold. I came upon it on that fool Anderson’s blog. He’ll be the first one that I kill, I fear.
When the nomination first came before me I laughed. I have been a member of the Nobel Physics committee for seven years and this was the first time any one had paid so little regard to the Nobel protocol that they’d submitted their own work, work that had not even been finished, much less published, for official consideration. I knew right then that this Anderson must be either a fool or a genius. My job was to figure out which.
When I began to look through the submitted equations that were purported to prove the Thomasine Confluence theory, I was appalled. They lacked coherence and anywhere that they crashed they were buoyed by the insertion of an unseen universe or a temporal inversion to sustain them.
Officially I derided them, in public it was easy to show that they deserved no more consideration than the lint under my carpets for serious candidacy for the prize, but it took me to the blog, and it was when I read the comments that I knew they’d begun to see the clues.
My name is Inganteria Moelusteian, but everyone calls me Tom, and yes I am that Tom, the direct spiritual successor to the apostle Thomas, Saint Thomas, Tommy Smothers, and Tommy Chong. The Rightfully Ordained Brother Thomas of the Order of the Thomasine Monks. I am the guardian of the secret of cynical thoughts, the doubters of truth, God’s own troublemakers. And now a small group of idiotic Americans had begun to post the secrets of our Order on the Internet.
My charge is clear, I must hunt them down one by one and eliminate them as a threat, by conversion to the true belief or transition to the inanimate.
Sunday, March 21, 2010
Sunday, March 14, 2010
The Thomasine Confluence
When I posted my little story The Ghost on my blog it produced an interesting set of responses, which I shall post here, via the magic of cut and paste, unaltered except for names.
“Sis: Enjoyed the blog, Tom. Glad you answered when opportunity rang the bell”
“Frank: Tom, are you sure it wasn't UPS...they ring once and run. And, we went to RMH for the Cardiac Unit's 2 year anniversary this afternoon. Shook hands with my Surgeon, his PA, nurses etc., who remembered me well.....when leaving, the Surgeon said "nice seeing you again - you look great, Tom".... When they made my name tag....they put Thomas (my middle name) instead of Frank....very - very spooky if you ask me....Tom.......VERY SPOOKY.....!!!!”
“Me: the world is a spooky place maybe he was in the wrong place”
“Frank: Which Tom was in the wrong place?”
“Ms CGS: or maybe the surgeon is a closet writer/blogger/prf. of English?”
“Ms CGS: Really enjoyed your blog, Scott.”
“Me: Frank, since you're the only Tom here, I think the ghost was a bit south of where he intended to be. Thanks CG. I don't know where it's going, but it will probably have to be edited some to get published.”
“Frank: But, you see, I'm NOT the only Tom here...you have a Tom there....You are just as much of a Tom as I am....mistaken identity?”
“Ms CGS: can I play? I'll be Tom the Editor.”
I was planning to answer CGS with a suggestion that if we were going to cast an attractive woman as Tom the editor, that she would have to be comfortable being a dominatrix that only wanted to edit you really, really hard. But then something struck me. It was both the tone and the content of those final two posts which led me to the conclusion that there was something larger going on here. So that meant it was time for me to get in gear and look into it, in only the way a piercing mind such as mine can possibly do it. It was time for some…tat da da daaaaaah…..(wait on it)……RESEARCH.
Now research is always a good answer when you have a vexing problem or coincidence to investigate, the problem becomes how, and what to research? Clearly, this doesn’t appear to be a religious problem, although there are examples of Thomas’s who play a prominent role in the bible, and there is always the possibility that we have all been simultaneously, because of our natural tendencies to scoff, and distrust been transformed into visages of the Thomas who doubted Jesus’ resurrection, but after due consideration and running a few preliminary mathematical equations, I rejected this as the explanation.
Biology was always a consideration, and I had to consider the possibility that some genetic sequence that we all possess in common is the root of our mutual Thomasine misidentification. So, I went out to the garage and fired up my DNA sequencer, and used a vacuum on my screen to suck DNA samples from the keyboards of each of your keyboards, by visiting your Facebook profile, and using direct screen-to-screen transport to shove the vacuum nozzle against your keyboard. I hope you don’t mind the intrusion. I looked at that and yes almost ninty-percent of our DNA sequences are similar, but Eighty-five percent of our DNA sequences match those of an earthworm, so I wasn’t able to draw any firm scientific conclusions from that. And while I don’t profess to speak fluent earthworm, I am unaware of any earthworms that refer to one another as Tom at all, much less it having some identifiable locus, so I was able to exclude those common sequences from consideration. The five percent remaining that the three of us have in common with each other, but not with earthworms seems to code for stuff like arms and legs and a four chamber heart and things like that, and not for name specific identity. So I rejected biology.
The answer then I reasoned must come from the realm of physics, specifically I gravitated to the subject of String Theory, and because it is such a fluid field, I adjusted and tweaked physical principles, added two unknown dimensions to account for Thomasine movement, a term I have now created, and viola there was the answer implicit in the very underpinnings of the science. We have only to look of the dual resonance model, first postulated by Veneziano in 1968 to see what is happening. In short, Veneziano observed that the s- and t-channel vibrations that occurred in meson scattering were of exactly the same amplitude, on further observation the exact phenomena was observed in N-particle amplitudes that gave us the idea of harmonic, opposing amplitudes like that which occurs in a one-dimensional model of linear string vibration. Obviously what is happening to us is an exact but opposite reaction, modulated through time by the presence of the two unseen dimensions of the great Brucine Confluence that effected Monty Python in the same years that Veneziano was developing his resonance model, and is only showing up now. I propose that we try to quantify B- (for Brucine) and T- (for Thomasine) confluent amplitudes and sit back and wait on the guys in Stockholm to send us that Nobel Prize I always knew I was going to get some day. I’ll start working on the math.
Scott
“Sis: Enjoyed the blog, Tom. Glad you answered when opportunity rang the bell”
“Frank: Tom, are you sure it wasn't UPS...they ring once and run. And, we went to RMH for the Cardiac Unit's 2 year anniversary this afternoon. Shook hands with my Surgeon, his PA, nurses etc., who remembered me well.....when leaving, the Surgeon said "nice seeing you again - you look great, Tom".... When they made my name tag....they put Thomas (my middle name) instead of Frank....very - very spooky if you ask me....Tom.......VERY SPOOKY.....!!!!”
“Me: the world is a spooky place maybe he was in the wrong place”
“Frank: Which Tom was in the wrong place?”
“Ms CGS: or maybe the surgeon is a closet writer/blogger/prf. of English?”
“Ms CGS: Really enjoyed your blog, Scott.”
“Me: Frank, since you're the only Tom here, I think the ghost was a bit south of where he intended to be. Thanks CG. I don't know where it's going, but it will probably have to be edited some to get published.”
“Frank: But, you see, I'm NOT the only Tom here...you have a Tom there....You are just as much of a Tom as I am....mistaken identity?”
“Ms CGS: can I play? I'll be Tom the Editor.”
I was planning to answer CGS with a suggestion that if we were going to cast an attractive woman as Tom the editor, that she would have to be comfortable being a dominatrix that only wanted to edit you really, really hard. But then something struck me. It was both the tone and the content of those final two posts which led me to the conclusion that there was something larger going on here. So that meant it was time for me to get in gear and look into it, in only the way a piercing mind such as mine can possibly do it. It was time for some…tat da da daaaaaah…..(wait on it)……RESEARCH.
Now research is always a good answer when you have a vexing problem or coincidence to investigate, the problem becomes how, and what to research? Clearly, this doesn’t appear to be a religious problem, although there are examples of Thomas’s who play a prominent role in the bible, and there is always the possibility that we have all been simultaneously, because of our natural tendencies to scoff, and distrust been transformed into visages of the Thomas who doubted Jesus’ resurrection, but after due consideration and running a few preliminary mathematical equations, I rejected this as the explanation.
Biology was always a consideration, and I had to consider the possibility that some genetic sequence that we all possess in common is the root of our mutual Thomasine misidentification. So, I went out to the garage and fired up my DNA sequencer, and used a vacuum on my screen to suck DNA samples from the keyboards of each of your keyboards, by visiting your Facebook profile, and using direct screen-to-screen transport to shove the vacuum nozzle against your keyboard. I hope you don’t mind the intrusion. I looked at that and yes almost ninty-percent of our DNA sequences are similar, but Eighty-five percent of our DNA sequences match those of an earthworm, so I wasn’t able to draw any firm scientific conclusions from that. And while I don’t profess to speak fluent earthworm, I am unaware of any earthworms that refer to one another as Tom at all, much less it having some identifiable locus, so I was able to exclude those common sequences from consideration. The five percent remaining that the three of us have in common with each other, but not with earthworms seems to code for stuff like arms and legs and a four chamber heart and things like that, and not for name specific identity. So I rejected biology.
The answer then I reasoned must come from the realm of physics, specifically I gravitated to the subject of String Theory, and because it is such a fluid field, I adjusted and tweaked physical principles, added two unknown dimensions to account for Thomasine movement, a term I have now created, and viola there was the answer implicit in the very underpinnings of the science. We have only to look of the dual resonance model, first postulated by Veneziano in 1968 to see what is happening. In short, Veneziano observed that the s- and t-channel vibrations that occurred in meson scattering were of exactly the same amplitude, on further observation the exact phenomena was observed in N-particle amplitudes that gave us the idea of harmonic, opposing amplitudes like that which occurs in a one-dimensional model of linear string vibration. Obviously what is happening to us is an exact but opposite reaction, modulated through time by the presence of the two unseen dimensions of the great Brucine Confluence that effected Monty Python in the same years that Veneziano was developing his resonance model, and is only showing up now. I propose that we try to quantify B- (for Brucine) and T- (for Thomasine) confluent amplitudes and sit back and wait on the guys in Stockholm to send us that Nobel Prize I always knew I was going to get some day. I’ll start working on the math.
Scott
Saturday, March 13, 2010
The Ghost
I don’t know much about ghost stories. I don’t like reading them ‘cause my life is scary enough as it is. You want to scare me you can hold the ghosts and tell me about a woman and her two daughters loose in Bergdorf’s with my credit card, now that’s what scares the hell out of me. As far as trying to tell one, I was never any good at ‘em. I usually messed up the scary part, and everybody’d laugh when they were supposed to be hollering and screaming. Although that happens about a lot of stuff, for me, the laughing part not the hollering and screaming. I guess it’s just the way I say things.
I remember once when I was just going into radiation oncology and was still doing a lot of work at the Children’s Hospital of the Kings Daughter. I was trying to tell a friend who I’d deployed with on dive jobs around the world about how it was making me feel. How I was running a lot better now because I wasn’t running through woods imagining getting away from Russians or Arabs or whatever, I was running down the streets of Virginia Beach trying to get away from the eyes of the dead children I’d taken care of.
His response wasn’t that helpful in trying to help me find a way to deal with the way I was feeling about stuff. He cracked up and said, “Man you should do stand-up. This stuff is hilarious.”
I changed the subject.
So if you’re hoping for a scary ghost story save yourself the trouble and bail out now, ‘cause that’s not what this is going to be. Anyway, Barry Hannah died this month. He was the kind of author that took chances, sometimes too many, but he was a good writer, for it and despite it too. He died up in Oxford where he taught creative writing, but I never knew him there. He was born here in the town where I live, Meridian Mississippi, but I never knew him here either. I went to the University of Alabama. When I was there we won the national championship twice, Bear Bryant was our coach, Sela Ward was one of our cheerleader, and Barry Hannah was in a drunken whirlwind, shooting arrows through folks houses, stealing motorcycles, and teaching in the English Department. That’s when I was aware of his existence.
I wasn’t the kind to get too impressed with a wild ass literature professor back then, I was in the honors English program and was studying Southern Literature because I liked it, but I was a pre-med major and all I gave a shit about was Biochemistry, and Physics, and Advanced Analytic Spectroscopic technique. My one stab at writing was a research paper on “The Clinical and Laboratory Characteristics of Macroamylasemia” a clinical syndrome where your amylase molecules are too big, with large redundant sections, so it doesn’t get excreted normally and you get high serum amylase levels. I’m pretty sure Barry wouldn’t have seen it favorably, as it didn’t take a lot of chances with the English language. Anyway, Airships had just come out, and one of the big stories that drew a lot of local ire was Constant Pain in Tuscaloosa. The constant pain had ended up with him in Bryce Hospital, the local inpatient psychiatric unit, for alcoholism. Which explains some things later in the story.
Now this morning was a rodeo Saturday at Casa Charlo (that’s the name we gave our new house, the last one was called The Monkey House because of all of the kids who lived in it with us). We were up a 5:45 am to get ready, get everything together; horses, trailers, trucks, etcetera so the girls could drive across the state to ride horses around stuff in a dirt pen somewhere else instead of here. I wasn’t going, so after I took them to breakfast and the barn and watched them drive away in a pick-up with a gooseneck horse trailer on the back I got to go home and go back to bed for another hour or so.
That’s when Barry showed up. Which was kind of disconcerting, because I’d known about him being dead for about a week or so. Anyway, I was lying there asleep and there he was, his hair was even still dark, no gray in it yet, althought he died with a bunch of gray hair. He was leaning over the bed and shouting down into my face, like he was famous for doing in class all those years ago.
“Tom…Tom…listen to me now Tom.” My names not Tom, but I figured it was the alcohol talking. “…just listen. You’re never going to be a real writer if you keep yourself all bottled up in your own life. You got to let go. You just got to let go and see what in the hell happens. Let your characters run their own lives. Stop getting in the middle of it. You gonna be dead soon enough, just like me. Write something worth leaving before you go Tom. God damn it, write something worth leaving.”
It never occurred to me that he might of gotten the wrong address, somehow I knew he was talking to me, he just had the wrong name, which wasn’t unusual back then either.
“So what is it you're trying to tell me to do, man?” I asked, still in college, I suppose.
“When opportunity knocks, you open the door Tom. Open the fuckin’ door.”
In the dream, I guess, I heard the doorbell ring and I was confused. Barry was gone and I didn’t know if the doorbell had really rung or not. The dogs weren’t barking. That was a sign that it was just in the dream, but I couldn’t just lay there. I got up and put on my robe and went from door to door and I didn’t see anybody out there. Opportunity had not knocked.
I tried to figure it all out, but it didn’t make sense. I poured a cup of coffee and sat down at my desk and rewrote the ending of The Hard Times , the novel I was editing, and I wrote well, which is always a nice thing. It was raining outside, the coffee was still warm, and I knew that while opportunity knocks and is gone, inspiration’s the one that takes the time to ring the bell.
I remember once when I was just going into radiation oncology and was still doing a lot of work at the Children’s Hospital of the Kings Daughter. I was trying to tell a friend who I’d deployed with on dive jobs around the world about how it was making me feel. How I was running a lot better now because I wasn’t running through woods imagining getting away from Russians or Arabs or whatever, I was running down the streets of Virginia Beach trying to get away from the eyes of the dead children I’d taken care of.
His response wasn’t that helpful in trying to help me find a way to deal with the way I was feeling about stuff. He cracked up and said, “Man you should do stand-up. This stuff is hilarious.”
I changed the subject.
So if you’re hoping for a scary ghost story save yourself the trouble and bail out now, ‘cause that’s not what this is going to be. Anyway, Barry Hannah died this month. He was the kind of author that took chances, sometimes too many, but he was a good writer, for it and despite it too. He died up in Oxford where he taught creative writing, but I never knew him there. He was born here in the town where I live, Meridian Mississippi, but I never knew him here either. I went to the University of Alabama. When I was there we won the national championship twice, Bear Bryant was our coach, Sela Ward was one of our cheerleader, and Barry Hannah was in a drunken whirlwind, shooting arrows through folks houses, stealing motorcycles, and teaching in the English Department. That’s when I was aware of his existence.
I wasn’t the kind to get too impressed with a wild ass literature professor back then, I was in the honors English program and was studying Southern Literature because I liked it, but I was a pre-med major and all I gave a shit about was Biochemistry, and Physics, and Advanced Analytic Spectroscopic technique. My one stab at writing was a research paper on “The Clinical and Laboratory Characteristics of Macroamylasemia” a clinical syndrome where your amylase molecules are too big, with large redundant sections, so it doesn’t get excreted normally and you get high serum amylase levels. I’m pretty sure Barry wouldn’t have seen it favorably, as it didn’t take a lot of chances with the English language. Anyway, Airships had just come out, and one of the big stories that drew a lot of local ire was Constant Pain in Tuscaloosa. The constant pain had ended up with him in Bryce Hospital, the local inpatient psychiatric unit, for alcoholism. Which explains some things later in the story.
Now this morning was a rodeo Saturday at Casa Charlo (that’s the name we gave our new house, the last one was called The Monkey House because of all of the kids who lived in it with us). We were up a 5:45 am to get ready, get everything together; horses, trailers, trucks, etcetera so the girls could drive across the state to ride horses around stuff in a dirt pen somewhere else instead of here. I wasn’t going, so after I took them to breakfast and the barn and watched them drive away in a pick-up with a gooseneck horse trailer on the back I got to go home and go back to bed for another hour or so.
That’s when Barry showed up. Which was kind of disconcerting, because I’d known about him being dead for about a week or so. Anyway, I was lying there asleep and there he was, his hair was even still dark, no gray in it yet, althought he died with a bunch of gray hair. He was leaning over the bed and shouting down into my face, like he was famous for doing in class all those years ago.
“Tom…Tom…listen to me now Tom.” My names not Tom, but I figured it was the alcohol talking. “…just listen. You’re never going to be a real writer if you keep yourself all bottled up in your own life. You got to let go. You just got to let go and see what in the hell happens. Let your characters run their own lives. Stop getting in the middle of it. You gonna be dead soon enough, just like me. Write something worth leaving before you go Tom. God damn it, write something worth leaving.”
It never occurred to me that he might of gotten the wrong address, somehow I knew he was talking to me, he just had the wrong name, which wasn’t unusual back then either.
“So what is it you're trying to tell me to do, man?” I asked, still in college, I suppose.
“When opportunity knocks, you open the door Tom. Open the fuckin’ door.”
In the dream, I guess, I heard the doorbell ring and I was confused. Barry was gone and I didn’t know if the doorbell had really rung or not. The dogs weren’t barking. That was a sign that it was just in the dream, but I couldn’t just lay there. I got up and put on my robe and went from door to door and I didn’t see anybody out there. Opportunity had not knocked.
I tried to figure it all out, but it didn’t make sense. I poured a cup of coffee and sat down at my desk and rewrote the ending of The Hard Times , the novel I was editing, and I wrote well, which is always a nice thing. It was raining outside, the coffee was still warm, and I knew that while opportunity knocks and is gone, inspiration’s the one that takes the time to ring the bell.
Friday, January 22, 2010
Title change
Just to clear things up for everybody that wonders what happened to DOWN THE TUBES, the title changed. Virtually every woman that was surveyed had a negative reaction to the title, so now it's called THE HARD TIMES, which is a better title anyway and fits the story as it is currently written. Working on where to go next, get the Bible and look at Numbers 35, then think about a graphic novel.
Monday, August 31, 2009
Hi world
How are you world? I'm still here, the Una Voce collection is finished and submitted to a publisher. Have written eleven chapters of a new novel, Down the Tubes, I don't know why any more, I guess I can't help it. I need to find out what happens to the little people who run around in my head. I was horrified when the hero revealed that he had had an affair and that his wife had known about it for years before she left him. I know where he's headed, I just don't know how he gets there. I guess it's kind of just like the lives that we think of as our real life. Hope I see some nice people on my way.
Friday, February 27, 2009
More and Less
Let me let you in on one of the basic facts of life, and no, you don’t have to be a doctor to know this one, everybody wants more- more money, more fulfillment from their lives, more love. If you need proof, look in the self-improvement section of any bookstore, or just turn on your television during the day and flip through the channels.
Why do we need more? Well, we need more money so we can get more stuff. Our society and our economy has been based on a simple principle…consume, consume, consume. When we hit a bump and consumer spending dropped the entire world economy stalled.
I hate to admit it, but I’m no different from anybody else. I fell hook, line, and sinker for the lure of “consumermania.” I can even believe that I need the newest two terabyte MP3 player… my crummy eighty gig is way too small, it only holds a thousand or so CDs. Who can put up with that? Unfortunately, as much as I delude myself to believe it is, my need isn’t a real need. I don’t have time to download a hundred CDs, much less a thousand. I have about thirty-seven CDs on my player, and yet I’m gullible enough to believe I need a newer, more technically sophisticated model. With the rapidity of technological evolution in the modern world, this cycle of need and fulfillment is never ending, as soon as I buy the new “two-T”, they’ll begin to advertise a newer model, one that comes with a cell phone in it, and as soon as I get that, there’ll be an even newer model with both a cell phone and a miniature computer in it, and so it goes ad infinitum.
In a lot of ways medicine is the same way, but instead of ego and vanity being the only driving forces, it may truly be that our lives are at stake. We want more and we want better, the heck with better, we want the best. Who doesn’t feel that they deserve the best health care? America is nothing, if not an egalitarian society, in this regard, everybody deserves the best health care, right? I don’t know. Let me pose a hypothetical question, what if there were a drug that was ninety-nine percent effective in preventing osteoporosis in post-menopausal women, and had no identifiable side effects, shouldn’t we give it to everyone that could benefit from it? Sure, that seems like a “no brainer”… but, what if it cost twenty thousand dollars a dose? Ok, well, that does seem a bit steep, but it really would make so many lives better, I guess we still should. The problem is, at that cost, for that many women, most of which will be sixty-five years old, or older, the cost of the drug will bankrupt Medicare in a single year. Now, should we make this wonder drug available to our Medicare beneficiaries? By the way, I hate the term beneficiaries, almost as much as I hate the term, health care provider. These are patients, sweet little grandmothers and mamas, wonderful women, and I am their doctor with this wonder drug that will make their lives so much better. No longer will they have to face the chronic back pain and the debility of nerve root compressions that are associated with the pathologic fractures of osteoporosis. Can I give it to them?
This isn’t a medical decision, medically, the answer is obvious. From a risk-benefit standpoint the drug is amazingly effective, so it’s all benefit with no risk. The only risk is to the solvency of the largest health care provider in the United States. So, this decision becomes not a medical decision but a social decision, a governmental decision, a legal decision, even a moral decision. If the recent financial downturn has shown us anything, it is that consumption has limits, and those limits are imposed by the availability of funds. We are currently in a position that requires that we make a decision on how we will impose limits so that our spending stays in line with the funding available to provide health care.
SGR stands for Sustainable Growth Rate and it's how our federal lawmakers have tried to limit the growth of Medicare costs in the past. They’ve tied the total amount of money that can be expended on Medicare to the United State's GDP or Gross Domestic Product. That means the value of all goods and services produced in the US during the preceding year.
Because our economy is, to say the least, less robust than it was a few years ago and the number of folks becoming Medicare eligible due to baby-boomers pouring in like a damn busted, things don’t work like they did when the law was enacted. The formula stopped working several years ago, and in the current economic environment would be a total disaster. Everybody knows it doesn't work; the lawmakers, the doctors, the hospitals, even the HHS folks who administer Medicare know. Guess who doesn't know? For the most part patients have no idea about the costly, intricate dance that goes on every year, with doctors and hospitals spending millions of dollars to convince the lawmakers to do what they know they are going to have to do anyway.
We need a better system. The nature of the system put in place to make decisions on health care will reverberate through the years, to effect, not just ourselves, but what type of a system our children have to look forward to.
The beginnings of legislation to establish a Federal Coordinating Council for Comparative Effectiveness Research was hidden by our newly elected president in the Economic Stimulus Package. The whole purpose of this council is to slow the development of new medications and treatment technology because they are driving up the cost of health care. This is similar to a board that governs who receives medical care and what care they receive in England and the United Kingdom. Medicare recipients will be judged on the perceived amount of useful life that they have left as to whether or not they will receive treatment for a given condition.
Will the egalitarian system we take as given, grant access to all to every technical step forward, or equally restrict access by all. Will equal access become a quaint naiveté` and give way to a two-tiered, or multi-tiered system of health care delivery, with the latest and best going to those who can afford it, and whatever’s left going to those who can’t? We would never stand for that, as a country, would we? We already do. There are forty-five million Americans without health insurance, the uninsured are now a sub-class, they don’t have access to the same preventative care and routine checks that the insured enjoy. As a matter of fact, even if they can afford health care, they may be afraid to seek it. There’s the big punch-a-roo, if they get diagnosed with a pre-existing condition, they may never get access to health care they can afford.
Do you know which segment of the population is the fastest growing pool of the uninsured? Poor people, right? Perhaps, the unemployed? Nope, on either count. That distinction goes to working males over fifty, that make over seventy-five thousand dollars a year. That can’t be right. That’s what I thought, until it happened to me. When a misrouted bill went unpaid, my insurance was cancelled without notification until sixty days after the action. And once you find out your policy has been cancelled, if you’ve gone more than thirty days without a bridge policy, you have to jump through hoops and throw around a good deal of loot to get any type of coverage. After several rounds of denials, and a total inability to get a private policy to cover either myself or my wife (every company was happy to cover our perfectly healthy children, for the same price we had been paying as a family). Thankfully, I have a good income and the cost of establishing a group policy and hiring my wife wasn’t an undue hardship, but it cost twice what I had been paying. Most families can’t absorb this.
In my opinion, any, health care reform has to deal with both of the issues; cost and access. Until there’s some type of insurance reform that actually reforms the practices of private insurers and provides a means for all Americans to obtain health care coverage in some form, any health-care policy we undertake is a mere band-aid. What is not intuitively obvious is that the elimination of the vast number of uninsured Americans will in and of itself drive down the cost of health care per capita. This is so because the cost of delivering health care to the uninsured is simply passed on to the insured. It is the only way hospitals and health care providers can survive in the current environment. Secondly, coverage of largely healthy younger people whose expenditures on health care do not exceed their premiums will help offset the costs of those individuals with higher costs.
If health care policy is going to be made in secret and obscured in the depths of legislation clearly intended for other purposes, any national dialog on how we as a country feel it’s best to address these issues, is subverted.
What is my message to those in power; the senators, congressmen, and the president? Stand up, be men, do not act in a secretive or cowardly fashion. America deserves the right to be included in deciding where our, and I repeat OUR, health care is going.
Why do we need more? Well, we need more money so we can get more stuff. Our society and our economy has been based on a simple principle…consume, consume, consume. When we hit a bump and consumer spending dropped the entire world economy stalled.
I hate to admit it, but I’m no different from anybody else. I fell hook, line, and sinker for the lure of “consumermania.” I can even believe that I need the newest two terabyte MP3 player… my crummy eighty gig is way too small, it only holds a thousand or so CDs. Who can put up with that? Unfortunately, as much as I delude myself to believe it is, my need isn’t a real need. I don’t have time to download a hundred CDs, much less a thousand. I have about thirty-seven CDs on my player, and yet I’m gullible enough to believe I need a newer, more technically sophisticated model. With the rapidity of technological evolution in the modern world, this cycle of need and fulfillment is never ending, as soon as I buy the new “two-T”, they’ll begin to advertise a newer model, one that comes with a cell phone in it, and as soon as I get that, there’ll be an even newer model with both a cell phone and a miniature computer in it, and so it goes ad infinitum.
In a lot of ways medicine is the same way, but instead of ego and vanity being the only driving forces, it may truly be that our lives are at stake. We want more and we want better, the heck with better, we want the best. Who doesn’t feel that they deserve the best health care? America is nothing, if not an egalitarian society, in this regard, everybody deserves the best health care, right? I don’t know. Let me pose a hypothetical question, what if there were a drug that was ninety-nine percent effective in preventing osteoporosis in post-menopausal women, and had no identifiable side effects, shouldn’t we give it to everyone that could benefit from it? Sure, that seems like a “no brainer”… but, what if it cost twenty thousand dollars a dose? Ok, well, that does seem a bit steep, but it really would make so many lives better, I guess we still should. The problem is, at that cost, for that many women, most of which will be sixty-five years old, or older, the cost of the drug will bankrupt Medicare in a single year. Now, should we make this wonder drug available to our Medicare beneficiaries? By the way, I hate the term beneficiaries, almost as much as I hate the term, health care provider. These are patients, sweet little grandmothers and mamas, wonderful women, and I am their doctor with this wonder drug that will make their lives so much better. No longer will they have to face the chronic back pain and the debility of nerve root compressions that are associated with the pathologic fractures of osteoporosis. Can I give it to them?
This isn’t a medical decision, medically, the answer is obvious. From a risk-benefit standpoint the drug is amazingly effective, so it’s all benefit with no risk. The only risk is to the solvency of the largest health care provider in the United States. So, this decision becomes not a medical decision but a social decision, a governmental decision, a legal decision, even a moral decision. If the recent financial downturn has shown us anything, it is that consumption has limits, and those limits are imposed by the availability of funds. We are currently in a position that requires that we make a decision on how we will impose limits so that our spending stays in line with the funding available to provide health care.
SGR stands for Sustainable Growth Rate and it's how our federal lawmakers have tried to limit the growth of Medicare costs in the past. They’ve tied the total amount of money that can be expended on Medicare to the United State's GDP or Gross Domestic Product. That means the value of all goods and services produced in the US during the preceding year.
Because our economy is, to say the least, less robust than it was a few years ago and the number of folks becoming Medicare eligible due to baby-boomers pouring in like a damn busted, things don’t work like they did when the law was enacted. The formula stopped working several years ago, and in the current economic environment would be a total disaster. Everybody knows it doesn't work; the lawmakers, the doctors, the hospitals, even the HHS folks who administer Medicare know. Guess who doesn't know? For the most part patients have no idea about the costly, intricate dance that goes on every year, with doctors and hospitals spending millions of dollars to convince the lawmakers to do what they know they are going to have to do anyway.
We need a better system. The nature of the system put in place to make decisions on health care will reverberate through the years, to effect, not just ourselves, but what type of a system our children have to look forward to.
The beginnings of legislation to establish a Federal Coordinating Council for Comparative Effectiveness Research was hidden by our newly elected president in the Economic Stimulus Package. The whole purpose of this council is to slow the development of new medications and treatment technology because they are driving up the cost of health care. This is similar to a board that governs who receives medical care and what care they receive in England and the United Kingdom. Medicare recipients will be judged on the perceived amount of useful life that they have left as to whether or not they will receive treatment for a given condition.
Will the egalitarian system we take as given, grant access to all to every technical step forward, or equally restrict access by all. Will equal access become a quaint naiveté` and give way to a two-tiered, or multi-tiered system of health care delivery, with the latest and best going to those who can afford it, and whatever’s left going to those who can’t? We would never stand for that, as a country, would we? We already do. There are forty-five million Americans without health insurance, the uninsured are now a sub-class, they don’t have access to the same preventative care and routine checks that the insured enjoy. As a matter of fact, even if they can afford health care, they may be afraid to seek it. There’s the big punch-a-roo, if they get diagnosed with a pre-existing condition, they may never get access to health care they can afford.
Do you know which segment of the population is the fastest growing pool of the uninsured? Poor people, right? Perhaps, the unemployed? Nope, on either count. That distinction goes to working males over fifty, that make over seventy-five thousand dollars a year. That can’t be right. That’s what I thought, until it happened to me. When a misrouted bill went unpaid, my insurance was cancelled without notification until sixty days after the action. And once you find out your policy has been cancelled, if you’ve gone more than thirty days without a bridge policy, you have to jump through hoops and throw around a good deal of loot to get any type of coverage. After several rounds of denials, and a total inability to get a private policy to cover either myself or my wife (every company was happy to cover our perfectly healthy children, for the same price we had been paying as a family). Thankfully, I have a good income and the cost of establishing a group policy and hiring my wife wasn’t an undue hardship, but it cost twice what I had been paying. Most families can’t absorb this.
In my opinion, any, health care reform has to deal with both of the issues; cost and access. Until there’s some type of insurance reform that actually reforms the practices of private insurers and provides a means for all Americans to obtain health care coverage in some form, any health-care policy we undertake is a mere band-aid. What is not intuitively obvious is that the elimination of the vast number of uninsured Americans will in and of itself drive down the cost of health care per capita. This is so because the cost of delivering health care to the uninsured is simply passed on to the insured. It is the only way hospitals and health care providers can survive in the current environment. Secondly, coverage of largely healthy younger people whose expenditures on health care do not exceed their premiums will help offset the costs of those individuals with higher costs.
If health care policy is going to be made in secret and obscured in the depths of legislation clearly intended for other purposes, any national dialog on how we as a country feel it’s best to address these issues, is subverted.
What is my message to those in power; the senators, congressmen, and the president? Stand up, be men, do not act in a secretive or cowardly fashion. America deserves the right to be included in deciding where our, and I repeat OUR, health care is going.
Friday, January 16, 2009
Where have I been?
It's Jan 2009, there haven't been any posts since November, what gives? I have been putting together a book based on the Una Voce columns. Am 3/4 of the way done. Will post more as we get closer to done.
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