National Healthcare

We now find ourselves in a national debate on improving health care for Americans. The rhetoric is flying, and so far little common sense has entered the debate. I have a few thoughts.

• Health care is not a right. I cringe every time I hear a person say that we have a right to health care. Rights are described in the Declaration of Independence, U.S. Constitution and associated amendments. No where in those documents will you find a right to health care. It would take a Supreme Court ruling to find that right. It may happen, but if it does we will have a good example of judicial activism.
• The United States Health care system is not broken. We have the best health care in the world. As with most things, you get what you pay for and ours is expensive. Our Canadian neighbors to the north have national health care. Why do those who can afford it come to the United States for health care? One answer, the care is better here than it is there.
• Medicare/Medicaid is not a model we can replicate. Many proponents of national health care claim that the government is ready to run the system. All that is needed is an expansion of medicare. It won't work and would likely cripple the U.S. health care system. The reason is that medicare is part of the problem. The rates paid by medicare are so low that many providers must inflate what they charge to private insurance plans to make up the difference. Expanding medicare would make the health care business unprofitable.
• Reward good behavior. Bad behavior such as smoking and obesity are the root of 80% of health care claims. The cost of health care would decline remarkably if office visits, surgeries, and hospital stays declined by a portion of the 80% of costs related to non-healthy behavior. Good behaviour should be rewarded with lower insurance rates. This is already occurring in some plans and by a few self-insured companies, and will work if implemented uniformly.
• Government is not the answer to lower cost. The government cannot be part of a competitive mix of health care plans. The reason is that a national health care plan would have the backing of the American taxpayer and the money printing power of the U.S. Treasury. A private insurance firm cannot be expected to compete with a government plan that may lose money, (as medicare does today), and simply pass the loss onto future generations in the form of debt.
• Competition by health care providers is required. If the average health care consuming citizen was required to pay for a larger percentage of their health care, you would begin to see consumers shop for the best deal. This would incent providers to become a lower cost option than their competitors. You would see hospitals, general care, and specialist providers retool their offerings so they could garner the most business. This model would dilute the cost of special equipment or services across many paying customers. Cost could be expected to decrease while quality could improve.

Those of us who believe that President Obama is moving to establish government control of the U.S economy know that common sense will never enter the debate. This is about growing government control. Health care is the next item to nationalize after banks, mortgage lendering, car and insurance companies. It is critical to the Obama plan.

Newlyweds

Allison Weber is my 20, almost 21 year old daughter. She married Jimmy Weber in July of 2007 when only 19 years old. Her mother and I initially discouraged the wedding, thinking that a couple more years of maturity would do both of them well.

I think you can reasonably say that they are still newlyweds since they have not yet made the 2 year anniversary. Yet, thinking back over the past two years, they don't fit the newlywed profile. It has been a tumultuous 2 years they have handled it with a maturity I could not have expected.

Let me start the story a year or to prior to their wedding. Jimmy's father, Joe, was a diabetic and generally in poor health. He spent quite a bit of the time Jimmy and Allison dated in and out of the hospital. Even when at home, his health was poor. During their courtship, Joe Weber died leaving his wife, Diane, and two sons, Jimmy and Joey. Joey is Jimmy's older brother and suffers from Muscular Dystrophy. He is effectively a quadriplegic and requires 24 hour care.

In July of 2007, Jimmy and Allison were married. Joey was part of the wedding party stood (seated) next to Jimmy. Jimmy and Allison moved into their first home together, an apartment a few blocks away from our house. What started out as a typical newlywed lifestyle soon changed.


On New Years Eve that same year, Diane became seriously ill and was admitted to Shawnee Mission Hospital via the emergency room. While the root cause of her illness was never determined, it caused her brain to swell and caused irreversible brain damage. She remained in a coma for the last week and a half of her life before dying in early January.


Diane's death left Jimmy and Allison with a decision. They could either find a state institution to care for Joey, or they could assume the care giver role. They choose the latter. Jimmy and Allison moved out of their first home together, and back into Diane's house so they could care for Joey. The greater sacrifice was not simply moving back, but rather assuming the care responsibilities. Those include ensuring state aid continued, transport for medical visits, school transportation, and management of in home nursing. It is a large responsibility for anyone, and not one that a newly married couple should have to take on. Yet, they took it on.


Over the past 18 months since the death of Diane, Jimmy and Allison have taken each challenge as they were presented. In addition, they were able to purchase and move into their first home and make it suitable for Joey's care. Their accomplishments were not easy, and my pride in both of them grows each week.


Jimmy and Allison: Hang in there. This is not the way it is supposed to be, it is just the way it is. You are handling it very well. It will get easier. Someday you will look back on this time with a sense of accomplishment in what you have done, how you did it, and that it was the right thing to do.

NutriSystem

A couple of months ago, I made the commitment to lose a few pounds. I have dieted once before using the Atkins method. It worked well for me as I lost around 25 pounds within a couple of months, and kept it off while on the diet. Since I am a red meat kind of guy, the diet came pretty easy. I did miss the bread and potatoes, but filled up every day on beef, cheese, nuts, etc.

After being on the Adkins diet for several months, Terri and I vacationed for a week in Charleston, South Carolina. I went off Atkins that week and gained 10 pounds in that one week. That seems to be the problem with that diet. Works well, but when you go off your body is very efficient at turning carbs into fat.

So now, several years later I need to diet again. Atkins is out since my doctor wants my cholesterol very low to guard against another stroke. Nutrisystem seemed like an easy diet. I saw Dan Marino holding a nice looking hamburger, and he lost 20 pounds in a single month. And you get to eat 6 times a day. I can do that!

Off to Costco to buy my first month supply of prepared Nutrisystem. My first mistake was assuming that Costco actually had the food. After paying the discounted rate, the clerk pointed me to a door where my order would be delivered. I asked the guy at the door if I would need a cart. He just smiled and shook his head. Then he went through the door and picked up an envelope and handed it to me. In that envelope was a Nutrisystem card that I could redeem online and get my order shipped to me. By nightfall the card was redeemed.

Nutrisystem delivered the order to my front door in about a week. Just as they promised, 1 extra week was delivered as part of my first order. I sorted it out and prepared for a new experience starting the next day.

First, the hamburger that Dan Marino advertises. Since all Nutrisystem food is non-refrigerated and non-perishable, there was no bun, tomato or lettuce. The dieter is expected to provide those essentials. The beef patty is another story. It comes in a cardboard box, inside a plastic tray and envelop. Preparation of the patty is to boil a small amount of water and pour it in the tray with the patty. The patty will then regenerate and heat. The flavor is not bad, but it is not nearly as appetizing as the one Dan Marino had in the advertisement.

Nutrisystem dinners are nasty looking, but taste pretty good. Entrees like meatloaf with mashed potatoes come in a plastic tray ready for the microwave. They taste fine, but always make you wonder how they can package the food with no refrigeration. The potatoes do turn a shade of tan, but are otherwise fine. The portions are small and when eating a Nutrisystem dinner, I know what Americans in Vietnam prison camps were thinking when they augmented their rice with insects. I have been tempted also.

The pizza always displayed in Nutrisystem ads are the worst food on the menu. First, the dieter has to put it together by spreading the sauce over pizza crust and then sprinkling cheese (that looks like plastic shards) over the pizza. After microwaving the meal, you are treated pizza that has the texture of a cardboard. Not the thin cardboard used in cereal boxes, but more like the thick cardboard used to box up appliances. It is very tough, hard to eat, and really not worth the effort.

Breakfast meals are okay. The pastries are pretty tasty, but just short of delicious. Cereal tastes like store-bought brands. Powered eggs with vegetable sausage is surprisingly good and easy to prepare. Pancakes are good (both of them). The oatmeal is horrible. You could patch your foundation with the stuff, but at least you know something is in your stomach when you finish. I couldn't eat all of the oatmeal they sent me.

Lunches are substantially soup. Black bean and tortilla, black bean and rice, split pea, and other flavors. All taste great.

Snacks are the only reason to try Nutrisystem. You get 2 a day and they are all very good. If I had the choice, I'd buy the snacks and leave the meals.

The one commonality for ALL Nutrisystem food is they are high in fiber. Even the chocolate pudding has a healthy dose. All that fiber puts a strain on your digestive tract, not to mention your friends, family and neighbors.

After two months of being mostly on Nutrisystem, I have lost 25 pounds. It was not as easy as Atkins, but probably a much healthier diet. It did train me to eat smaller portions, and that is something I can use as I go off the diet. I will be interested if that helps me keep the weight off over the next few months.

I am a Stroke Survivor, Part 3

June 11th, my 51st birthday marked my first day home as a stroke survivor. I felt pretty good and all I was required to do was take a mild blood thinner for a year and visit with the neurologist every quarter. For the first couple of weeks I experienced some weakness on my left side and slurred a few words, but the impact was not too noticeable. I took 2 weeks off before returning to work, and played golf (poorly) in the week that followed my release. So in my mind, things were returning to normal.

Terri may disagree and could have a little different recollection. She noticed that I was going though demeanor changes. I was far less patient than before, far more impulsive, and could quickly become irritable or mad at things that would not have bothered me in the past. As I put time between myself and the stroke, I too could see these changes. Although not as severe, some are still with me today.

Time has also allowed me to see that my logic and behaviour in the days following release from the hospital were odd. My check registry for that time period is full of errors. I would sometimes use a credit card, but enter it in the check registry. Other times I would use my check card and not register the transaction.

One day I received a new transaction card for our savings account. Thinking it was a new check card, I destroyed my old one, and tried to use the savings card as a check card without success. In my mind, the bank was horribly screwed up as it was all their fault.

After returning to work, I do remember one instance of confusion at an intersection near my place of business. I actually pulled out in front of a car that had the right of way. Luckily the other driver avoided collision. I do not recall other problems driving, but that one was close.

As time passed, the confusion lessened. The only affects of my stroke now are that I am quicker to anger than I once was, and sometimes I briefly forget names of those I am vaguely acquainted with. When presenting concepts or projects at work, I will stumble on words, or they will queue up in my head much faster that I can speak.

Terri might have other beliefs on how I have changed. In fact, she may have corrections on many of the events I have written about. One thing that was learned about right side brain injuries is that the victim is not aware of a problem, and is completely unaware of the strange behavior they may exhibit.

I am thankful for many things. Thankful the stoke was not severe with permanent disability. Thankful that I have not had a recurrence of the problem. Thankful that my employer was understanding an patient with my recovery. But most thankful that my family, especially my wife Terri, has put up with my strange behavior and moods, and still love me. Thanks babe, I love you much.

I am a Stroke Survivor, Part 1

It was Wednesday, June 6th, 2007. Terri and I were planning to fly to North Carolina for vacation on the following Friday. I was at work clearing out my pre-vacation to do's. It was lunch time and I was spending it as I usually do, quietly in my cube eating a salad and reading my email. I do recall that I was a little tired and attributed it to yesterday's blood donation followed by mowing the lawn in the summer heat.

I remember pressing the print button and getting up to go pick up the printed email from the printer. My next memory is that I was slumped over the printer as a friend and peer manager was asking me what was wrong. Later I was told that I had been seen clumsily wandering the floor, bouncing off of cube walls, and unresponsive to those I encountered.

After stumbling into one cube, I frightened and worried the resident enough that he reported it to his manager. I stated to the peer manager who found me that I was fine, just a little tired, I had a sinus problem and might have lost my balance. I could have come up with 10 more excuses, but she wasn't buying any of it. I was sat down in a chair, and another co-worker with a medical background took a closer look at me. He too thought that something was not right.


My boss was informed and the para-medics were called. Upon arrival, the para-medics also saw that something was not right with me. They questioned me on drug and alcohol use, and pressed hard on whether I had been dringing over lunch. After repeated denials the para-medics made the decision to transport me to the hospital based on their assessment that I probably had some sort of medical issue.


I was wheeled out of my place of business on a gurney as many of my co-workers watched. My boss called Terri and informed her of the situation and then followed the ambulance to the emergency room of St. Luke's South Hospital. I was quickly admitted to a triage room and assessed. Blood was drawn and sent for testing.


I felt normal and was responsive when Terri arrived at the hospital. She did notice that I displayed some left sided facial droop. The ER doctor indicated that I had probably experienced a TIA (Transient Ischemic Attack) sometimes referred to as a mini-stroke. Since these are by nature "transient" and do not leave lasting damage, there was thought that I would be prescribed medication and released with follow up testing. I asked to use the restroom and got out of bed. My left knee gave out and I stumbled. That was TIA #2. Immediate release was now out of the question and I was admitted to ICU.

My case was given to a neurologist who determined from an MRI that I have a genetic narrowing of an artery in my head, and this was the likely location of the TIA. The source of whatever temporarily stuck in the narrowing was now the issue that needed an answer. Some consideration was given to placing a shunt in the artery however, as the neurologist put it, prior attempts with other patients has less than desirable outcomes (what did that mean?).

ICU was an interesting place with private rooms and lots of nurse attention. The nursing staff commented on how I did not fit the profile for an ICU patient or a stroke victim as I did not smoke, had low cholesterol and average blood pressure. Regardless, there I was in an ICU room after having the most significant medical event of my life.


I will continue this story tomorrow as I went through a battery of tests in an attempt to find the source of a clot or plaque that may have led to the TIA. At this point, my main goal was to get released from the hospital in time to make a Friday morning flight to North Carolina. The neurologist led me to believe it was still possible, even as Terri tried to dissuade him. After all, she did not want to get stuck in North Carolina with a sick husband.

I am a Stroke Survivor, Part 2

So on June 7th, 2007, I find myself in the ICU of St Luke's South Hospital. I am 4 days short of 51 years old, this is not supposed to be happening. The day began a barrage of tests. I think I saw all the testing hardware available at the hospital. Sonogram, CT scan, and echo cardiogram tests were among the first to be performed. Each were intended to find the source of the clot or plaque that caused the TIA's. All turned up no evidence.

Vacation was planned for the next morning. Could we still make it? I lobbied the neurologist and nurses hard. I wanted to go! Late in the day, Terri and I met with the neurologist and I was successful in convincing him to release me with medication and a promise to return for testing after vacation. We were going to North Carolina!

But then TIA #3 hit, complete with facial droop. In a matter of minutes, my condition turned from ready for release to seriously ill. It is not normal for a patient to have 3 TIA's over 2 days as this usually portends a serious stroke is imminent. Good bye North Carolina, hello St. Luke's Brain and Stroke Center.


I was immediately transferred to the St. Luke's downtown location that specialized in caring for brain and stroke patients. The next few days were spent visiting other hardware for tests, all of which were not conclusive. Fortunately, I experienced no more TIA's. The final test, an angiogram, was the gold standard for vascular problems. In this procedure, the doctor made a small incision into my leg, and fed a wire into an artery, through my heart and into my brain. From there they released dye just below the suspected TIA location as they watched a real time video of the blood supply in my brain. I too was able to see what they did.

The dye was released as I felt a surge of warmth spread through my head. On the monitor, all the blood vessels in my head immediately became visible. From this, the doctor was able to tell that this was no longer a case of multiple TIA's. The restricted blood flow had killed a small portion of my brain, so the diagnosis was now that I had a minor stroke. The vessels around the damaged portion were already redirecting blood around the area.


Still the source of my problem was unknown and may remain that way forever. Fortunately, I have not had recurrence of a TIA in the subsequent 2 years. So on Sunday, June 10th, I was discharged from St. Luke's Hospital. In the third and last blog on this subject, I will describe what has happened since my stroke.

Obama's Popularity

News flash: President Obama's job approval rating is beginning to slip. From a high of 65%, it has slowly fallen to 59%. Of greater note, his job disapproval rating has grown from a low of less than 20% to the current 34%. You maybe surprised of this since the mainstream media does not report bad news for Barrack. So what is going on? My opinion, which is pure speculation, is that the is that the uninformed populace is starting to get a clue on where Obama wants to take this country. And they are not thrilled.

On average, the Obama supporter is not the most well informed voter. In fact, many did not distinguish Tina Fey or John Stewart comedy routines from actual news stories. The mainstream media contributed to this by repeated airing of current events along with the gags during nightly news. Also remember that Saturday Night Live was given a prime time evening time slot as the election neared. Many, including this writer, believe this was a conscious decision by the media leadership to help a far left Barrack get elected in a predominantly conservative country.

And while ABC and NBC provide the Obama administration with unprecedented access to unchallenged media time (for example the recent national health care infomercial), conservatives continue to hunker down in fear of losing even more of their power.

Let's look at Barrack's significant accomplishments since inauguration:
As promised, a tax cut was given to the vast majority of citizens. Did you notice it? Mine worked out to be around $7 a week. I think may of us tax payers were underwhelmed.

Closing of Guantanamo Bay was promised. A plan was never defined, so this promise remains unfulfilled and will likely stay that way until a governor raises his hand as says he will take the detainees. Not likely.

The Federal Government now owns a majority stake in Insurance, Financial, Automobile Manufacturer, and Mortgage lending businesses. This country's economy was built on capitalism, not nationalism or socialism. Many are now seeing this direction as a way of increasing the power of the national government. Do you hear that thump, thump thump? That's Thomas Jefferson spinning in his grave. Barrack will win the debate if he can turn these companies around and recover tax payer dollars. If he fails, we all drown in hyper-inflation caused by printing money.

A Cap and Trade bill is passing through the Congress. Couched as an environment bill, the true intent is to limit the amount of energy each citizen can afford. The United States will then be seen as good global citizens, using only their fair share of the worlds energy resources. Surprisingly, this proposal hits the poor the hardest as they will be the first live in homes that are too hot or too cold.

A Supreme Court nominee was presented to the Senate. Many thought Barrack would extend an olive branch to conservatives by nominating a middle of the road successor to Justice Kennedy. Instead, he went hard left with a judge who claims that experience gained by gender and race can be used to make constitutional decisions.

Troop drawdown in Iraq is underway. While far too early to tell if he can successfully withdraw from Iraq, Barrack's base feels he has moved far too slowly on this. His campaign timetable was to immediately begin drawing down troops.

Projected deficit has quadrupled and the national debt debt is expected to double. Never in American history has so much deficit spending or national debt (in real terms or as a percentage of GNP) been planned in the forward looking budget. I believe that nearly all Americans understand that debt is bad, and more debt is worse. Using the administration's own figures, Obama will rack up more debt in his 4 years, that all presidents from George Washington to George Bush combined.

National Health Care is now on under consideration. Many of the citizen supporters are not aware that Barrack's plan will not be free. Instead, they may be required to carry and pay for a level of health care insurance they currently do not. It will be interesting to see how fast they run from their "right" to health care.

When you consider the potential long term consequences of these initiatives, it is no wonder that his job approval rating is in decline. The wonder is that it is not falling at a faster rate. As more of his base becomes aware of the sharp left turn he is taking the country, they will begin to question it. As energy costs increase, they will feel the pain in their wallet they thought would be administered only to the "rich". In the end, Barrack's a job approval ratings will fall into the George Bush range. Does that make Barrack a bad president? Absolutely not. The contribution a president makes is sometimes not seen for years after his administration leaves office. Short term opinion polls are not good gauges on the effectiveness of an administration.

For those of us who bothered to listen to the presidential campaign carefully, this is no surprise. Obama's history and his rhetoric clearly indicated where he planned to take this country. Unfortunately, many chose to listen to the flowery speeches and bias media reporting instead of what the candidate was saying.