Get Hip!

Well...

You probably know - I complained about it enough - that my right hip went very decidedly bad on me about this time last year.

It'd been coming apart for some time before that; I'd lost about 1/4" to 3/8" off my right leg starting back in about 2011. It was sore, and a little awkward. I went to a couple of orthopods who told me that I'd be getting a new hip...but that if I could hold off longer that I'd be happier with the long-term results.

So I did. And the leg seemed to stop deteriorating; I managed with minimal discomfort and the same shoe lifts I got from the physical therapist in 2011 for about four years.

Then, last winter, the leg really started to go to hell. Painfully, to begin with. It HURT. And I began to really lose bone in the hip joint; by early summer I was an inch shorter on the right side than the left, and was wearing a real no-shit cripple shoe on my right foot just to be able to walk at all. And walking was fiendishly painful. I have a fairly high pain tolerance, and by mid-autumn I was pushing right to the extreme edge of that limit.

I was ready by November to get the damn thing parted out and replaced. But that's when The World's Best Health Care System^TM kicked in. Because I hadn't worked for my current company a full year (never mind that I'd worked for the sonsofbitches damn near four years in my earlier incarnation...) I wasn't covered by the disability insurance policy. AND I would lose my health coverage, period, if I couldn't work 20 hours a week.

So I put off the surgery until March.

On March 1 I went under the knife.

I don't really know what the surgeon did and, frankly, I don't want to know. The entire notion of being opened up like a beef carcass, my femur cut off at the proximal joint, drilled out, and a metal rod slammed into it is faintly sickening. And the surgeon's assistant, questioned afterwards, described an interior hellscape of floating bone chips and towering arthritic spires that had to be picked out or ground off, respectively. I was a mess inside which seems to have gone a long way to explaining how painful the thing was. I had lost a lot of blood in the OR, and my blood pressure remained low for another day or so.

To kill the pain of this flensing I received a spinal anesthetic. This is not a "block", as I had assumed - similar to the epidural that is common for knee surgery or caesarian section - but a general anesthetic delivered through the spine. And it works, delightfully. I awoke Tuesday afternoon in very little pain. I couldn't feel my legs, but, then, hey...there's always tradeoffs, right..?

That happy condition lasted until about Tuesday evening as the spinal began to wear off. I began to take the pain medication - oxycodone, "hillbilly heroin" - at low doses. Not ideal, but...manageable. The OT and PT people got me up and walking, frailly, but walking. The hip hurt, but...differently. This wasn't the deep, grinding pain of the disintegrating joint but post-op pain of sliced and sewn-together muscles.

Wednesday afternoon I was released, and hobbled on my walker down to the main door of Good Samaritan and my Bride in the Subaru.

Getting into and out of a low vehicle when you've had a hip replacement is ridiculously balletic. First you have to lay the seat back far down so you don't have to bend at the waist. Turn backwards to the door. Stick your new hip-leg out and lower yourself down, leaning back until you're almost supine, your legs sticking out the door like a dead mobster in a videogame. Then you scoot far up the seatback - to clear your feet from the front of the doorframe - and swing them inside. Then you slide forward, and if you want you can put the seatback up a bit.

Then you have to do that all backwards to get out. I did, and tottered up the steps, into the house, and into bed.

And that night, the pain came.

The nighttime hours between Wednesday and Thursday might have possibly been the worst of the entire business. I went from 5mg every three hours to 10 to 15; by midnight I was lying awake, unable to find a comfortable position to lie, begging the clock to move to the next time I could take another painkiller. I've been in pain at various times in my life, but that was about as bad as I've ever hurt.

And by Thursday afternoon the pain was, largely, gone.

Not that it was gone-gone. I still hurt when I get up after sitting a long time; the joint stiffens up and I have to hop and limp a couple of steps to loosen it up. But by the weekend I had gone from the walker to a cane. After a month I dropped the cane and haven't needed it since.

I still have, and will always have, a deep gouge in my right hip.

Now I am ten weeks post-op. I have some lingering soreness. As I said; I can't sit for long without stiffening up. But the overall pain and discomfort level is far, far below what I was living with just three months ago. My legs are nearly the same length; I have a half-inch lift in my right leg and always will - until my left leg goes bad and I have to have THAT hip replaced...

I won't pretend that I'm happy about all this. I shouldn't have to have had this hip replaced at all; I'm not sure what happened, whether it was just bad luck or bad genetics or misuse - I did abuse the hell out of my legs when I was younger - or a combination of all the above. But I shouldn't have to have aftermarket parts in my goddamn hip and I'm sure as hell not pleased that I do.

But.

Given that I don't have a choice, the alternatives could be worse. I am free of the constant nagging-to-screaming-out-loud pain I have lived with for nearly five years. I can walk straight again, and hopefully soon dispense with the last of the "precautions" which prevent me from, for example, tying my right shoelaces.

Call no man happy until he is dead. But...I am a happier man than I was back in February, and, perhaps, that is enough. For now.

Aftermarket parts

The prolonged silence around this joint is largely because I'm pretty much in the terminal segment of the descending branch of my appointment with the MOPAR guy; I'm getting a total hip replacement next Tuesday. My right side has gotten so bad that just moving is painful and small children point at me and scream when I hobble past. Yes, I look like The Hunchback, you little bastards. I know.

I won't pretend I'm thrilled. Yes, the result will be better than my present crippled mess. No, it's not "good". It's just better than what I have. I am still resentful and angry that I've been dealt a shitty hand and can't do anything but play it out. There are also the risks attendant on any large surgery AND the time and effort that go into a painful recovery. Like a Republican voter, I'm angry that I have to deal with the painful and difficult present to get to the promised better future that may or may not arrive.

Speaking of those fucking idiots...is there anyone who can pretend that something like 15-20% of the U.S. electorate hasn't lost its fucking mind? I mean, here's a guy who is just a ridiculous buffoon, a raw, infiltered Id-iot demagogue that has openly espoused torture, racism, aggressive war and domestic espionage. Closing houses of worship? Seriously? You'd think that even a mouth-breathing cousin-marriage-spawned Christopath would have been out the door on THAT one.

Speaking of which...this year's Republican primaries have done a great job of reminding me why political Christianity - at least, as it commonly appears in the "conservative" spectrum of U.S. politics - appeals to me about as much as a solid dose of the clap.

Fred Clarke notes that it's not a matter of some sort of individual choice on the part of the bible-bangers as much as it is a complete failure of the Christian Right to include any sort of genuinely Christian ethics in their catechism;

"...the Christian moral formation of these supposed Christians they have not been offered an adequate inoculation against this kind of politics. What they needed was instruction in a version of Christianity with ironclad commitments to civility, solidarity, justice, mercy, compassion, rule of law, and human rights, commitments so strong and so well-engrained in believers that to support someone like Trump would be unthinkable. But they have not received that inoculation."

This isn't just Trump. His closest rival, Ted Cruz, spouts similar noxious bullshit, and the Jesus-pesterers eat it up.

The full effect appears to be that the "vulgar talking yam", as Pierce likes to call him, is all over the GOP like stank on an old gym shoe. Barring a complete disaster he will be the candidate this fall, and I cannot imagine a worse indictment of the goddamn U.S. public. The GOP cannot help this nation in any way if it is the Party of Trumpism. There is nothing that can be said other than what I've said here again and again; Ceterum censeo GOP esse delendam.

The GOP serves no real useful purpose at this point. And, worse, in its existing form it is destroying the political conventions that make U.S. governance possible. We’re rapidly approaching 1859, and for much the same reasons only instead of slavery the hothouse ideology “threatened” by change is some sort of hellbrew of racism, greed, and flopsweat panic fear of imaginary jihadi invasion.

And stupidity – if you’re voting for Republicans because you’re mad at the wealthy vulture capitalists shipping your job overseas you’re in the same position as a pig voting for Jimmy Dean. Racist, greedy, and stupid is no way to go through life, son, and yet it's pretty much the default Republican position on, well, everything.

Oh, yeah, and there's their take on the fucking Malheur Morons. Oddly, the only one of the clowns that hasn't openly embraced the Metal Mulisha is Trump. Probably because they lost, and losers lose; Trumps are winning winners that win! Christ on a fucking crutch.

Nuke it from space. Seriously. That’s the only fucking way to be sure.

Oh, one more thing since we've been talking about Il Douche; at least he gave someone the inspiration for this:

Gad, what a vile shitshow these people are.

Did I tell you that the Girl has taken up the ancient sport and combat skill of archery?

She and the Bride have been going to our local Trackers indoor range to shoot, and both of them have become damn proficient, the Amazons. Speaking of which, my inamorata - who is still abundantly endowed even after going through surgery to reduce the endowment - says that she has developed a whole ne appreciation for the old story about the women warriors being, um, monomammilary. She has to alter her stance fairly significantly to about getting slapped with the bowstring in a rather delicate place.

Sometimes I'm damn glad I'm not female. The discomfort setting seems pretty high.

Anyway, Trackers is pretty much made of awesome. We're talking a place where you can live-action roleplay, or learn to smithy a utility knife, or card wool and spin cloth, or find medicinal plants. I would have been all over Trackers if we'd had one whan I was a kid, and I love the Little Miss loves her some Trackers.

Here's a couple of snapshots of the two maenads firing away. Here's the Girl:

Mojo takes up a good kneeling unsupported firing position:

Contemplating the perforated foes:

Good shooting, ladies!

I've enjoyed all this Robin Hoody exercise, although my personal fantasy is as a Parthian horse-archer at Carrhae, and so as such I've tried to duplicate the tactic of starting with my back to the target, stringing, turning and firing.

Let's just say that the Parthians and I are lucky I was born 2,000 years too late.

But not late enough to have bionic hips. Dammit.

Waiting for Bob...

I've got a confession to make.

I an on an artificial testosterone medication.

Yeah, I know; sorry, TMI. But that little fact is fairly critical to the rest of this post, so I had to start with it. Try to scrub the image out of your brain. I'll wait.

OK, so, we good now?

Alrighty, then.

So, anyway, the bottom line is that as I headed into my forties I noticed that I was having some problems just dragging my ass out of bed in the morning. That and, well, the usual sort of problem associated with not being packed with robust man-juices, but we won't linger on that particular issue.

I went to see my internist, who ran the usual blood tests and pronounced me perfectly functional, 100% mission-capable.

Which left the issue of "Why the hell is my dead ass dragging so badly?" and I asked for a referral to a urologist. Since it didn't cost my GP a nickel she happily wrote out the referral and off I went.

The dick-doc then ran the same blood tests and proceeded to inform me that my natural testosterone levels were down there with those usually associated with very masculine women and pre-pubescent boys. I could creep up into the low three figures on a good day with a following wind and a strong current, but that was that.

So he prescribed me one of those artificial testosterone medicines that help professional bicycle racers win the Tour de France and off I went.

And the stuff works as advertised, let me tell you. In a couple of days I felt positively bursting with masculine energy; I wanted to seduce something or go start a war.

Kidding. But, seriously, the man-juice works. I felt "back to normal"; my energy levels in all respects returned to what I expected to feel given how active I was and how hard I worked to keep in shape and eat a healthy diet.

Well, OK, except for the whole pork-rind thing. But, damn, who can resist that crackly, greasy goodness? Seriously.

And because the urologist explained that this stuff was to restore my testosterone to natural levels as a matter of health and quality-of-life issues and not because I wanted to become some sort of mad harem-tester in my off-hours my insurance - after some initial suspicious sniffing - proceeded to cover the damn stuff.

Dick-stiffeners, though? Viagra? Cialis? Not a chance. Despite the usual whining about how all those boner pills are covered and female products aren't...they're actually not. That's just so you know the deal here.

Anyway, this was some ten years or so ago. I've been taking these testosterone supplements regularly ever since and, although the damn co-pays go up and up every year, paying just a portion of the actual price of the stuff.

Which is pretty ridiculous, mind you, given that the drug is decades old and is manufactured at some sort of drug-maquiladora in Mexico for probably pennies a dose. I mean, we're talking hundreds of dollars for a little pump-bottle that lasts about a month; well over $3,000 a year at full price.

Three. Thousand. Dollars.

But the damn insurance has been paying for this, so for the cost of $500/month or so in premiums I get a reliable supply of man-juice.

Until yesterday.

When my Bride returned from the grocery pharmacy without the testosterone bottle, explaining that the pharmacist had input the prescription and it had spit out that the drug was no longer covered by my Blue Cross/Blue Shield formulary.

So.

Now I am faced with the unlovely prospect of having to call my goddamn insurance company and 1) find out why the hell they are no longer covering my drug after ten years of doing so and 2) figure out how the hell I can get the goddamn insurance company to stop dicking around (if you'll excuse the expression) and cover the goddamn drug again. This will undoubtedly involved repeated conversations with unpleasant insurance company phone-bots whose purpose will be to find reasons not to spend the money I have been ladling into the goddamn insurance company's bank account on my health care.

And to make it as difficult and unpleasant for me to find a way to jerk that money out of their ass a nickel at a time.

And as I'm staring at my phone with a sense of deep loathing for this entire process, I keep thinking: remind me - this is that "best healthcare system in the world" we keep hearing about, right? Because we don't have some faceless bureaucrat deciding what and how we will get for our health care. Right?

Because right now I'm about ready to shove every goddamn insurance company up the gigantic bung-hole of the Universe and replace them with a single faceless government health care organization just like the one I had when I was a GI that paid for whatever my docs said I needed without so much as a whimper.

That, or go score some fucking Enzyte.

What a goddamn disaster.

The Dealer Folds

The ortho and I both looked at the black-and-white picture on the wall.

"So you can see the deterioration here, and here. Both the condyle and the acetabulum are involved. There's just not a lot left to work with."

I could see that. Yes.

Last year I began to notice some difficulty reaching my right foot.

Nothing sudden, or startling. But it got difficult to bend my right leg at the hip, and I found that I had to perform an odd contortion of waist and knee to do simple things like tie laces or trim nails.

Have I mentioned that I have this knee problem? I think so. It's my parent's fault. Really; I have a congenital knee malformation called "patellar subluxation"; my kneecaps look outwards, are turned towards the outside of my legs. This has caused the outside of the kneecap to wear on the outside of the knobby parts of the leg bones (the condyles) and has reduced the bony parts of my knees to a pretty tattered state. I can jog briefly, and walking is usually fine, but running more than a short distance will result in a sleepless night of sore knees and Motrin.

So I thought this might be some sort of complication from the knees. Until this winter, when the stiffness and loss of range of motion began to be accompanied by pain in my right hip.

It started as just a soreness after a hard day at work, or playing soccer with the kiddos. But by May it was a constant soreness than ranged from a barely detectable hum when I sat quietly or walked slowly to a startling sort of wince if I tried to run or kick.

Finally in June I went to see my internist.

Like every American today I can't just "go to the doctor". I knew perfectly well that I had some sort of skeletal problem; likely related to age, hard, use, and deterioration (which didn't stop me from occasionally indulging in lurid nightmares about bone cancer or some other gawdawful fright) but clearly beyond the purview of a general practitioner.

But - also like every American today - my medical life is controlled by a massive bureaucracy. Not a government agency that I could petition for relief, but an insurance company that operates like a Sumerian god; opaque, dictatorial, and random.

So to appease the Gods of Blue Cross off to Dr. Le I went.

I love Le. She's this shrewd, no-nonsense character that talks like a B-girl from a Vietnam movie.

"What you do? Mess this up?" she said, poking me in the hip. I winced.

"Yeah, doc. I think I got a bum part and I need to go to Third Shop for an overhaul. You know a good bone wrench?"

"You go see Doctor Langwire. He hip man, Portland Ortho. He check you out."

Sure enough.

So with my all-important referral slip in hand, I spent a sunny afternoon having my leg manipulated by a physician's assistant and getting an x-ray. Which the doctor and I were both looking at now.

"If you were 75 or 80 there would be no question." the orthopod looked me up and down, "I'd be recommending a new hip. Yours is among the worst I've seen, and that includes men in their nineties."

"But..." I already knew the but, having read the little "Total Hip Replacement" brochure, the one with the little old man on the cover.

"Hmm. Yes. But the level of activity possible with a replacement hip would be very restrictive for an active man in his fifties." The doctor paused and looked at the x-ray again. "And there's the issue of functionality; a replacement today would probably mean another before you were seventy. And second replacements tend to have complications, especially if the person, again, intends to remain active."

Complications.

Yeah, I'd read that, too. Hip replacements aren't what you tend to think; you don't go skiing the next week. They're really quite fragile, you have to be extremely careful about things like inverting your leg or the thing will dislocate. Dislocations run about 5-6%, and, remember, we're talking mostly about old gaffers in the seventies throwing a hipjoint out shuffling down the grocery aisle to pick up some stool softener.

"Honestly, doc; what would you do."

To give him credit, I think he really thought about it.

"Well, I'd lose some weight". We both looked down at the thickness around my middle. I like to think of myself not so much as...fat...but as "dense". But I'm fat; I've lumbered around 230-240 for the past decade, ever since my knees really packed in.

"And I think I'd exercise to the best degree possible. And I think I'd try and keep my original hip as long as I could. Because when it becomes too much to go on, you're going to lose a great deal of what you can do now, and never recover that. You will be able to walk again without pain, though. Which at that point might be worthwhile."

I thanked the man, and walked out of the big, airy office in the old Pearl District brickstone building, and got in the work truck, and sat behind the wheel for a long, long time.


I don't want to make some sort of big tragedy out of this. I can do most things just fine. I have a terrific job, a wonderful family, I make a good life in a city I love. If you pressed my I'd have to say that the past nine years - my married life with Mojo and our kids - have been the best years of my life.

But my body is starting to fail me, and that's never happened before.

And I will admit; I abused the hell out of it, me, and the U.S. Army.

I threw it around, and piled heavy loads on it and told it to go past the point where it told me it was ready to stop. I made it bend and stretch in ways it didn't like, and hurled it against hard objects until it protested by swelling up and whining creakily. In my twenties, thirties, and forties I walked and ran further and faster than most Americans do in a lifetime; I climbed everything from hills to mountains, lifted and carried, squat, knelt, and sprawled. I played contact sports for my own entertainment that towards the end would see me with ice packs on both knees.

But every time I asked it to work or play for me, my body always responded. Not always gracefully - in fact, I'm to grace what Republicans are to compassion, an utter stranger - but always.

And now it's starting to just quit.

The doc was right. I'm not ready to become an old man, shuffling along at a slow walk for exercise, worrying constantly about making a sudden turn or sharp movement that will produce the instant screaming agony of a dislocated hip.

But the options are not good.

There's something called a "hip resurfacing" that offers a better joint architecture and a lowered chance of dislocation, and I need to look into it. And I'm not bragging myself when I say I have a pretty high threshold of pain, and I think I can go a fair bit before it becomes too bad for me to take.

Oh. And the last time I weighted myself I was down to 217.

So that's something.

But the damn plain fact is that I've been dealt a pretty shitty hand. I'm a 53-year-old man with the right hip of a sickly seventy-year-old. There's nothing I can do about it, and I can't even really whine about it, since it gave me a better run than most Americans before abuse and my fat ass packed it in.

It's the hand I have, and I just have to play it out.

But I don't have to like it.

And I don't.

Die, Freedom!

It's embarrassing for a political junkie to admit, but I completely passed on the "health care reform" debate and votes this weekend.

Part of this was having two active and busy kids (and part of a third, with Christine's little guy the Poet coming over Sunday afternoon to give her a break), part of it was wanting to stay on top of home and house business.

But a big part of it was simple disgust.

This issue has become a Ministry of Silly Walks, really, and I've long since gone past irritation through anger to revulsion and into indifference at the ludicrous posturing over what is really a very minor adjustment in the U.S. medical system.

The reality is that the fundamental dysfunction - the idea of making a profit off giving medical treatment to the sick - is unchanged. The fee-for-service and for-profit health care business will, therefore, continue to swell up and swallow more of the nation's wealth. The well-duh realization that pretty much the whole rest of the world has reached - that sick people don't and won't "shop" for bargains, that the disjunction in knowledge-level between the medical "provider" and "consumer" is so huge as to be unbridgable and prevents even a smart guy like me from "shopping" for medicine even if I wanted to, and that the complete lack of external controls, either regulatory or market-based, on medical costs virtually ensures that they will bubble until they grow beyond sustainability - has utterly escaped us.

No, this is a band-aid on a tumor, and although it will help a relatively small group of Americans get medical insurance it stays well away from doing anything to actually help reform the for-profit system.

What I did get out of this mess, however, is the degree to which the U.S. party system is broken, and that because one of the two parties has become flat-out, no-holds-barred, bug-fucking crazy. Let's elide the usual political bullshit (John Boehner’s argument, for example, that you won’t be able to keep your health insurance under this plan is just a lie. But we've come to expect this sort of lying by now.) and look at some of the top GOP quotes on the health-care issue (courtesy of Alterdestiny):

Tom Price (R-GA): "If health care passes, "We lose our morality. We lose our freedom."

John Shadegg (R-AZ): "This bill will destroy freedom and do damage to the very fabric of our society."

Marsha Blackburn (R-MN): "Freedom dies a little bit today."

Devin Nunes (R-CA): By passing health care reform, Democrats "will finally lay the cornerstone of their Socialist utopia on the backs of the American people. For most of the 20th century people fled the ghosts of communist dictators. And now you are bringing the ghosts back into this chamber."

Waa...hunh? Obama is Stalin? Forcing people to buy expensive insurance is the COMINTERN? (Guess nobody told the auto-insurance KGB, hunh?) Freedom dies when poor people get medical coverage? Baby Jesus weeps when insurance companies don't get to kick people off their insurance when they get cancer? (Oh wait, they still do - there's nothing in here that prevents rescission.)

I do believe that these gomers are talking out their fourth point of contact. They don't REALLY believe any of this "freedom is dead" rhetoric. The problem is that there's a whole bunch of mouthbreathers out there that DO believe it, and this sort of playground bullshit gets and keeps them worked up.

You can't keep a republic when a third of the citizens believe that passing civil legislation in a majority-vote fashion means "We lose our freedom."

I've said this before, but it bears repeating. One of the deadliest things a republic can do is allow one group or faction to put it's interests not before the interests of others but before the interest of a functioning republic. If one side stops accepting that the other gets a turn at the helm, then there is no solution but conflict, and if one side stops accepting the results of that conflict as played out with votes then it must be played out with guns and ammunition.

Based on this sort of language the GOP, circa 2010 is already most of the way there. And where is the alternative? Where is there a place for the "conservative" who doesn't want to hector people about profit!abortiongaysgunsandGod?

WASF.

Why people hate insurance companies.

So back in October my little guy went in to the doc for a minor operation.

It really was minor, the removal of a tiny skin tag which, had it been anywhere else, would have involved a local dab of xylocaine, a snip, a band-aid and a lollipop. But this one was on his eyelid, so we had to go the entire operating theatre route to keep him still enough for the plastic surgeon to whack it and throw a single stitch.He did a great job, and you can't even see where this goofy thing was. And his classmates no longer tease the Peep about his freaky eye booger.

But while the skin tag is gone, the medical bills keep coming, reminders of the Byzantine fucking complexity of our medical system.

There's the hospital bill, the surgeon's bill, the lab bill, the anaesthesiologist's bill...

And then there's the insurance claim, and that's where the REAL frigging mess begins.

Because nothing's simple there. There's the billed amounts, the "provider's discount" (WTF? So you're telling me that the physicians, surgeons and the hospital had padded the bastard enough to knock the official billed price down 30% or so and STILL make a profit?), the amount we have to pay on our personal deductible, the amount not covered because it's part of our family deductible, the part not covered because it's part of our "total-out-of-pocket" expenses, the part the insurance plan covers at 80% and the part that it covers at 60% (forget 100%, Giacomo...that don't happen...)I've been calling the insurance company and talking to all of these very helpful, very knowledgable people...it's hard for me to hate them personally. But the entire system requires a tremendous amount of unpaid time on my part to track down this information and try and apply it to everyone's bills.

And then I talk to my parents, who lived in Dusseldorf for many years, and they tell me that when my mother saw the doctors there she got a single bill, with a cost, the amount paid by the national health (usually something like 90% or better) and the amount they owed. They were done with the nonsense when they walked out of the clinic or the hospital.

Plus there's the irritation factor. Why the hell didn't Blue Cross apply the $500 that Mojo paid upfront to Peep's deductible? And once they do, and once we pay off the remaining $750 we owe to cover our $2K "out-of-pocket" costs, why do they then not pay their expected 80% of the anesthesiologist's bill, on which they have payed nothing?Add this all together and I'm left doing a slow burn; hating the insurance company for doing what private insurers have to do - making it difficult for me to spend their money and fuck up their balance sheet - and causing me to spend all this time on the phone, hating the medical providers for complicating the billing process and padding their costs, and hating the people who are so worried that this wonderful system is going to be "changed" by health care reform.

And I'm a pretty sharp guy. Makes me wonder what the dull-normal people do when they have to deal with this stuff..?

I mean, it's better than bleeding and purging, but, still...

Just when you thought the "heath care reform" debate...

...couldn't get any stupider.There's this:

"In promoting the House health bill, New Jersey Democrat Frank Pallone made reference to discrimination by insurance companies, citing their reluctance to insure people with preexisting conditions and differences in costs based on gender. "But that's not against the law," Texas Republican Pete Sessions said.

Pallone replied, "No, but we would make it against the law. Why do you have a problem with that?" he asked. "Why should a woman pay more than a man?"

"Well, we're all different," Sessions explained. "Why should a smoker pay more," he said before getting interrupted by a burst of chatter throughout the room."

Got that, bitchez? You need to get you and your every-so-much-more-complicated va-jay-jay out there under the awning in the rain with the smokers and the rest of society's lepers.

'Cause you just too different and complicated.

If you wanted to save money you should have been born with a penis like Real Americans.

Jesus wept. We are governed by fools.

Field Day

I'm living a sort of good-news-bad-news joke today.The bad news is that the business picture for my business hasn't gotten any better so, as advertised, my employer has cut the staff hours down to 24 per week.Working - or not working - a three-day week pretty much sucks. Getting by on 60% of your normal income isn't a good thing, either. But there's not much I can do about it at the moment, anyway, except try and look at the good-news aspect, which is that if I am going to have to take a day off without pay, today was a good day for it. The weather is gorgeous and my little boy's "Field Day" was today, so I got to go over and play with him and his little kindergarten classmates as they raced and jumped and wriggled and were otherwise as energetic and adorable as a clowder of kittens.After Field Day I went and had a delicious leisurely lunch at the Little Red Bike Cafe, absolutely a Cool Thing in North Portland, and spent the next several hours doing household chores, making phone calls to try and reduce our spending on things like insurance, cable TV and the Internet, and re-reading Diane Gabaldon's entertaining "Outlander", as much fun now as it was when I first read it several years ago. Watched part of a truly bizarre Johnny Weismuller "Jungle Jim" movie on TCM and taped the UEFA Champions League Final - I haven't watched it in hopes of luring Brent and his current inamorata Heidi over to see it this weekend, but...go, Barca!And then sat down to post this.At some point today a friend from this blog, Charles Gittings, is going to try and drop in. He's passing through between Seattle and California, where he's getting some medical work done, and his situation got me thinking of medicine, health care and the contretemps surrounding "health care reform".I think, and have thought for some time, that the way we distribute and pay for our medicine in this country is beyond flawed. It is, quite literally, insane. The notion that sickness and injury need to somehow become profit for everyone involved except the sick or injured person, from the insurers to the doctors to the hospitals, clinics, laboratories and hospices...that's lunacy. It's like making war for profit, or making love for profit. The incentives for misbehavior are legion, and the restraints on any sort of mischief, well...Atul Gawande has a good piece up at the New Yorker that looks at this as exemplified by the little town of MacAllen, Texas. It's not pretty, and it should make you think.

The bottom line is that sick people or injured people are going to need care. And only the most over-rich communities can afford such care without some limits on the amount and the cost. So in some way that care will be rationed. At the moment we have chosen to ration care by income. If you are wealthy, you can afford care without limit. Make a living wage and hold down a decent job - and remain relatively healthy - and you can still afford a lavish regime of treatmeent for your ailments.

Become old, or sick, or unemployed...well, one hopes that Illness will be merciful and Death will be kind.That seems fundamentally unjust. Does the elderly woman dying in her broken bed in her unheated shack love her life less than the elderly woman in her soft sheets and elegant bedroom? We seem to believe so, for we have set up a system that punishes the poor and rewards the wealthy. One suspects that this is a reflection of our political system, which empowers the powerful and disenfranchises the powerless.I wish I saw a change in the future. I do not. The forces arracyed against such a change are simply too strong.Oh, and the pictures are all from the Astor School 2009 Field Day. Go, kindergartners!