matthearn.com

Eek. I find this letter from the director of the Congressional Budget Office to be disappointing:

Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.

Read at least the first few pages for more detail. I’m frustrated because one my big arguing points on the subject of universal healthcare is that it would save money, long-term; it may not. Does that mean it’s not worth insuring the millions of un- and under-insured Americans? I don’t know.

Some good news, however, on the media front:

What just happened in three short days?

With one statement about the “public option” from Obama, the entire health care reform discussion shifted totally away from the right wing crazies and Palin’s “death panels” In just three days with one statement about the “public option”, liberal Democrats who stood on the sidelines and barely jumped in to the death panel discussions, have finely stirred off their duffs to get into the fray and argument.

In just three days, the media has shifted its coverage away from the crazies and the lies and finally, some meaningful media attention to the real issues on the health care reform effort. In just three days, the whole debate on health care reform has turned around and hopefully, now the debate and discussions can be about the real issues and real health care reform can happen. Meanwhile, the ultra conservative right wing has been stymied. Obama is brilliant!

Huh.

So I’m lifting in the gym earlier, doing my leg press so that I don’t look like this poor fellow, and another fellow comes in. He’s wearing regular street clothes, so I’m thinking he’s one of the “light workout” types, comes in for a few reps on the nautilus at low resistance, and then leaves. But no.

He strips his polo off, revealing the beater underneath, and drapes the polo on one of the weight benches, adjusting it to angle. Fine so far. He then leaves it like that and lays down on ANOTHER bench to do some pretty serious benchpressing. Huh? Was he just…reserving the first bench for something? After the bench pressing, he takes the shirt off the first bench and drapes it over the bench press bar, and then gets a paper towel and puts it on the first bench. He also retrieves two 35-pound dumbbells and sits them next to the bench. Having reserved his various pieces of exercise equipment for his personal use, he goes over to the nautilus and starts using one of those machines as well. What the hell?

What kind of self-centered prick do you have to be to reserve equipment you aren’t using, so that it’s free when you’re ready for it? If I’d known we could do that, I would have just pissed on everything to mark it ahead of time. What a dick.

Man, I’m in a mood today. I should stop doing steroids, probably.

No racism or anti-semitism at the town halls, huh? Sigh. Have they no shame? Don’t these folks understand that they are bad people for doing these things?

Sorry for the light day yesterday; as you might expect, things are CRAZY in Hearndom. The time I normally use for scheduling posts (after the kids are abed) is now reserved for cleaning, packing, painting, etc. I’ll try and keep things entertaining around here.

The healthcare debate is raging, and regardless of your opinion, reading information from “average joes” is often helpful and interesting, particularly if “average joes” include patients, doctors, insurance agents, and other important players in the debate. If you’re interested, I’d recommend you go explore this round-up of Andrew Sullivan’s readers, writing in with their 8 farthings.

Something I had not previously considered: Does killing terrorist leaders actually do us any good? I think we would instinctively say “yes,” but Robert Wright points out that there is a fairly inexhaustible source of terrorist leadership, something that we only increase by killing civilians in our quest to kill terrorists.

It becomes clearer and clearer to me that military action doesn’t do nearly as much good as we’d like to think. Catching and punishing criminals should always be a function of police, not soldiers.

Ever wonder what it’s like to be a Cleveland Indians fan? Nurse The Hate can tell you. (Note: naughty words.)

Once again the white flag of surrender proudly flies over Progressive Field, and the team has sent all the core players packing, unable to pay them what the market will pay in upcoming seasons. It’s hard to believe really. Six months ago the organization was talking playoffs. Now two of the top three in the pitching rotation are gone. Plus, the set up guy, and four of the starting position players have been dumped for minor league players 2 years or more away from possibly playing at the Big League level…

The question I have as a ticket buyer is why do I have to keep shelling out for this bulls***? The answer is, of course, I don’t. And neither does anyone else, as the Indians attendance has slipped to 27th out of 28 teams. I am stuck with 5 more games in my season ticket package at $50 a game to watch minor league players audition for next year’s team. Not to worry though, as a customer I am very excited to hear from the head of the Indians organization that once every ten years they might be able to compete. Where do I sign up for my 2010 tickets! Whoo!

There are, of course, 30 major league baseball teams, but other than that it’s spot on.

Patrick Appel, posting on Andrew Sullivan’s site, has a pertinent reader comment on the current healthcare situation, which helps explain why I think a public option is not an unreasonable intrusion on the marketplace.

The problem with predicting medical expenses is that, even though you can find the codes (they’re called CPT codes and you can find them here) you would have to get the price from the doctors’ billing coders, which they would probably be loathe to give out- how can we expect the market to work when the consumers don’t get to know the price BEFORE consuming? …If you have the time to sit down and do the research, it would be nearly impossible for the average person to make an accurate decision about the most cost effective doctor to have. Imagine trying to make that decision in a panic.

(Italics mine.)

I’ve had this funny spot in my vision for a couple days, and also I haven’t seen an optometrist in roughly ever, so I scheduled an appointment to have my peepers examined yesterday. I’m the only person of my age that I know who doesn’t wear any kind of corrective lenses, but recently things have been…not necessarily blurry, but definitely less well-focused than they were ten years ago. It was time.

I knew the basic drill from what my various friends and family reported, so I read off the letters and words and impressed the hell out of the technician by reading the bottom line of the close-up card without even squinting. Then Dr. Nguyen came in and we got down to Business. He put the big metal Mardi Gras mask in front of me and started twisting dials, checked for astigmatism, all that good stuff. Then he grabbed some eyedrops off the shelf, which I assumed were to dilate my eyes, but instead he said “These are a bit of anesthetic, they may sting a bit,” and quickly dropped them in before I could ask “what exactly are you about to do that might cause me pain?” which turned out to be an important unasked question.

Then he flipped off the lights and used another tool with a bright blue light to look at my eyes, and tossed off the following sentence like he was asking a waiter for an extra spoon: “I’m going to press this blue light against your eyeball. Open your eyes wide.”

You’re going to do what now?

Hey, uh, could you not, um…okay, bright blue light, getting closer, that’s close enough, OKAY PLEASE STOP PRESSING THE BLUE LIGHT AGAINST MY EYEBALL and he pulled it away.

“Now for the other one!”

Um…do we have to, uh…wait…wait…no…BRIGHT BLUE LIGHT AGAINST MY EYEBALL AGAIN TOTALLY NOT COOL and we were done.

“Ocular pressure’s totally normal.” Yeah, thanks for that.

Also thanks to everyone who had had this procedure done but didn’t warn me that SOLID OBJECTS WOULD BE PRESSING DIRECTLY AGAINST MY PUPILS. Awesome times.

After that, he did dilate my eyes, and to rule out a neurological reason for the funny spot in my vision, he had a technician do a peripheral vision test which I passed with flying colors. After my pupils were as big as pupils have any business getting, he shined a painfully bright light around my retinas for a while.

“Okay…first of all, your vision’s 20/15. You don’t need glasses.”

Just like Ted Williams!

“I do see a little scarring on your retina…” (Perhaps from the fact that you just shined an automobile headlight into my eyeball? Just throwing that out there.) “…but that’s normal.”

The funny spot is probably just the eyeball equivalent of a bruise, and will probably disappear soon. Yay! I don’t have eyeball cancer or syphilis or something!

“We’ll see you next year for another appointment!”

Great, ’cause it’ll take me that long to forget what it was like to have A BRIGHT BLUE LIGHT PRESSED AGAINST MY CORNEA.

Here’s something that occurred to me last night whilst falling asleep: what do the various new healthcare insurance reform bills say about pre-existing conditions? The standard view seems to be that insurance companies shouldn’t be able to deny claims on that basis, since it certainly does look bad on TV when someone appears and says “I had cancer, and Blue Cross Blue Shield wouldn’t cover my treatment!” because BCBS says “Oh, you had cancer before you signed up.” Obviously, if the person didn’t know she had cancer, that’s BS.

But it certainly is a problem for an insurance company if someone avoids getting coverage because they can’t afford it or just don’t feel like spending money on it, and then they find out they have a serious medical problem, and they sign up for healthcare to get free treatment. Obviously the company isn’t going to want to pay for this, and I’m not very excited about what it would do to the premiums of even a public plan. Since President Obama’s thoughts on the subject seem to be that no one is going to be forced to get healthcare, but that no one should be denied coverage based on having a pre-existing condition, what’s to stop me from just cancelling coverage on my entire family and then buying it when one of us gets sick?

Reading the above, you might think I’m against the public option. Not at all. I don’t think it goes far enough; I think we need single-payer, ideally in the French style, which allows for additional coverage to be purchased from private insurers (in the way many companies offer coverage to seniors to go along with Medicare). Unfortunately, that’s off the table.

Anybody have any answers?

Andrew posts an email from a reader:

I was struck by two different views of America yesterday. On the one hand the Town Hall protesters who seemed elderly,white,scared and come across as unwilling to listen, and on the other hand the two freed journalists who seemed young,with ethnically diverse families and friends, and came across as generous and open minded.

The first group has become emblematic of the Republican party. The second group were surrounded by Democrats. Is there any doubt which party is winning the battle for the future?

I ain’t sayin’. I’m just sayin’.