Archive for March, 2011
We’re about one week out from the big day: April 4 Gabriel gets his cast off. We cannot wait. It’s like looking forward to Christmas. It’s such a big deal that the four-year-old can tell you how many days are left, counting them himself.
Gabriel has lost a lot of weight. The original rash that caused us so much trouble was doubly hard to deal with because Gabriel filled his entire cast with no difficulty whatever, which made it very hard for air to circulate and his skin to get better. It was also difficult for us to get our hands inside the cast to put the cream where it needed to go. Not anymore. Gabriel eats very sparingly, and though we ply him with fatty treats – he had pie this morning for breakfast – he’s still markedly thinner than he was. Some of that will be muscle tone, but a lot of it is that he doesn’t eat much. We’ve had little success with anything we’ve tried there.
We took him to church today, the first time since the injury. He wasn’t quiet, but he liked being there. A couple of people remarked at how thin he was. We’d be worried, but he’s always been a picky eater, and he’s still got great energy. There’s only a week left. He’s not going to starve to death.
He has also discovered mobility again. He army-crawls across the floor – he loves the tile entryway and kitchen for this – and he rolls over and generally scoots himself around. Today he also stood up for a bit, which is hard to imagine, with his legs splayed our crablike as they are, but he managed it. I doubt he’s going to have any trouble with mobility once the cast comes off. In seven days. Did I mention that?
He still stinks. The cast is awful. But there really isn’t much we can do about it. We’ve tried all sorts of things, but none of them really work very well. It’s just something we have to work with and endure. There have been a lot of those things.
Gabriel is sleeping better. We have him upstairs now, in his brother’s bed, where he can sleep a bit longer and not get awakened by his siblings getting ready for school. That’s working.
Something I didn’t mention was that we have been having him wear his 7-year-old brother’s shirts. Beefers, the aforementioned 7-year-old, seems okay with this. The larger shirts work better, because they drape down over the open top of the cast, and prevent food and other things from getting down into the cast, where they could cause significant problems. They’re also easier to get on and off him, which is a bonus for us.
We’re tired. We’re very ready for this to be done. But we’ve learned a great deal, and we’re far more sensitive to the problems other parents face, most of which, honestly, are a lot more severe and long-lasting than what we have to deal with.
The last bill is in, we think. The ambulance bill came this last week. It wasn’t as much as we thought it would be. I’ll line-item the expenses in a post later this week, but suffice it to say that we are incredibly blessed once again. We’ll have payments of a decent size to make for a long time, it looks like, but we could have been crippled by this and we will not be. We are not going to be bankrupted. We can deal. Your faith and your prayers have worked a miracle here, for which thing I am grateful beyond words.
I say that I don’t believe in Medicaid, and people look at me quizzically, so I feel I should explain.
Yes, I believe there IS Medicaid; it’s not like the tooth fairy. The program exists. I believe, however, that it shouldn’t.
Having been in politics for approximately 104 years, I know what saying stuff like that means. I know that the first reaction of most people, when I make a statement like that, is “so you want millions of people to die in agony. I see how it is.” Of course, you all know that I actually DO want millions of people to die in agony, being a heartless, cruel, and sadistic human beingcastic.
Note: my family decided a while back that since there was no designated sarcasm font, that we’d adopt -castic as a sarcasm tag. Anything you want to label as sarcasm, just put the -castic tag at the end of the word or phrase and that tells everyone the tone to use when reading what you wrote. So handy!
So that I can make this post less than 3000 words, which you have neither time nor (probably) inclination to read, I posted my “Why Medicare is a Disaster” explanation here. Suffice it to say in this space that the current system is terrible both for consumers and even more for providers, and that it’s going to go from agonizing to crippling to fatal if we don’t do something about it. And that something is going to be painful in its own right.
Being an astute reader, you are now saying to yourself, “okay, the system sucks, but it is he system we have, and since you’ve paid for it like everyone else, and you genuinely need to use it, why wouldn’t you?” And this is a very good question. I’ll do my best to explain.
Government is broke. Your government and mine, it’s bankrupt. There isn’t money to pay for all the things its trying to provide. What’s consuming our tax money faster than anything else is what are called “entitlements”, things to which we are entitled as citizens. Social Security, food stamps, FHA-guaranteed loans, Pell Grants, Medicare and Medicaid, and several hundred (really) other programs cost huge sums of money and provide relatively small benefits in comparison to the money expended.
I like this analogy: we have cereal on one side and hungry people on the other side. We need to deliver the cereal to the people. The usual implement to use in this case is what we call a spoon. But spoons are small. It takes a lot of them to feed all those people. Some people find that they have to wait to get fed, and they complain, and then the elect representatives with a mandate to feed people faster. So the politicians take the instrument they have – government – and use it to feed people. What government is, is a backhoe. It’s a huge, powerful, and ridiculously imprecise instrument for this purpose, but it does move a lot of cereal really fast. Of course, feeding people by backhoe is insanely wasteful. It’s the wrong tool for the job. But politicians have no other tool. Spoons are private-sector instruments. So government extorts money from those people, and uses it to fuel the backhoe. This means that fewer and fewer spoons are used, because money that would have gone to spoons is now going to government. Why feed people with spoons, anyway? The backhoe will do it.
And then, oh, and then the cereal runs out. Not everyone is fed! We need more cereal! More backhoes! But there comes a point where there isn’t any more cereal, no matter what you do. That is the point we have reached in this country, though few are willing to admit it. There simply isn’t enough money to do all the things government is trying to do. Some people are not going to get fed. Or educated. Or many other things.
Explanatory Note: there is a point where raising taxes does not increase revenue. The math on this is done by what’s called the Laffer Curve, and it attempts to show at what point increasing tax rates actually reduces revenue. There is such a point. You can argue that we aren’t anywhere near that point right now, but I will think you’re wrong, and I have a lot of company. The only way other than taxes to handle government debt obligations is to inflate out of them, because as inflation doubles and trebles the denominated dollars that the debt has to be paid with, so it simultaneously cuts by half and two thirds the face value of those obligations. I.E. if you owe me $50, and inflation makes your $20 bill double in value, you can pay me off a lot easier. Your debt stays constant, and your dollars multiply. There are other consequences, though, and they are not nearly as pleasant. But the government doesn’t have to eat, so inflation is not nearly so harmful to it.
Hence Wisconsin. Governor Walker sees that there isn’t any more money, and tries to reduce what the government has to pay out. This produces a monthlong backlash of violence and thuggery not seen since desegregation, perpetrated by those people who are going to be fed less by the government backhoe, as if they had some right to consume tax money. But folks, that’s only the first of many. Most states in this country are in similar – or even worse – situations. Their turn is coming.
And the federal government is in worst shape of all, and is even more incompetently led. State governments can get themselves squared around (well, some of them can, California, Michigan, New York, probably not), though that turn is painful, but the federal government, even if it stopped right now doing a gigantic volume of things, couldn’t cut enough in time, because we as a people would scream bloody murder. We won’t take it. We’re too soft. We’re too greedy. I get no pleasure from saying these things, but they are true. The “Tea Party” is an attempt by a large group of citizens to say “enough”, and try to get the government appetite down to sustainable levels. It almost surely won’t be enough. But it’s a noble attempt.
This kind of thing, trying to wean people off the government, is the sort of thing that causes strikes, unrest, and in extreme – but by no means rare – cases, civil war. People give up with great reluctance the things they’ve come to expect, and even feel that are theirs by right. They will often do violence to you for attempting to take those things from them. Given, then, that what’s going on in Wisconsin and Tennessee and elsewhere is potentially the great debate of our time, and bears directly on the future of the Republic, if there is one, I feel honor-bound to be on the side I believe in and advocate for. That’s the side that thinks these programs shouldn’t exist.
I also belong to a really radical fringe group that thinks that if you’re going to advocate for removing some federal programs, that you should 1) not be taking advantage of those programs and 2) know what hardships will come to those that do not and 3) be willing to shield others from those hardships insofar as you are able. If I’m going to talk about eliminating Medicaid, and I am, then it would be well for me to know what it’s like to try to live without it. I cannot, therefore, in good conscience, accept any money from any federal programs that I think should be eliminated.
And that’s why I can’t take Medicaid.
Full disclosure: I once did take it, when I was much younger and not as prone to think things through. Alexander was a Medicaid baby. I also took Pell Grants to go to school. Knowing what I know now, I wouldn’t have done that. But I did do it once, and I neither condemn those that do, nor look down on them for doing so, nor do I have any difficulty understanding why most people think I’m nuts for behaving this way. Here I stand, I cannot do otherwise.
The alternative would be a system in which medical expenses were handled by a combination of private insurance and direct-paid medical care, with cash set-asides and tax credits as an incentive to underconsume rather than overconsume. But this post is too long already. Suffice it to say that I support a system that would put spoons in the hands of those that need to eat.
One of the things to understand when we talk about Medicaid is that everything costs. The cost is often not in dollars, but that doesn’t mean that the cost disappears. At BYU, for instance, student tickets to sporting events cost money, but not very much. If you get an all-sports pass, which is a screaming deal, you attend any game you like from that point on, as many as you want to. So the internal pool of all-sports students gets its tickets for “free”. But the tickets are not free, not even after the initial price is paid. If you want to go see Jimmer play, you better get in line, and get in line early. By the end of this season, you had better have been willing to camp out, or you weren’t getting in. And those tickets cannot be re-sold. They let you directly into the Marriott Center, and you go sit. A couple hours before the game starts. That’s a cost, in time and effort.
Now, for BYU that has one spectacular benefit, and that is that the fans that get into the game are the ones that are the most committed to the team and the game, otherwise they wouldn’t be willing to spend the time to get in to see it. This generates rabid fans and ratchets up the intensity of the experience. So the team plays better and the entertainment level is higher and everyone wins. Since BYU wants craziness from its fanbase, what BYU is doing is good because it selects for those qualities that BYU values most.
Unfortunately, most programs that operate on a similar basis select for exactly the wrong thing. Free goods – those things that have no obvious price tag on them – get overconsumed. Imagine for a moment if a grocery store gave meat away for free. How much steak would you get? You’d get a lot of it, that is, if you could get it at all. I saw this in communist Hungary. People had money to buy things, but there was often not that much to buy. When the goods showed up, the lines began.
There’s another, less obvious downside. That is the impact of the free good on the seller. What incentive does a seller have to keep the good in stock? Or to provide service to go with it? He’s not being paid for selling it. The demand is gigantic, no matter how crappy the quality. So the seller doesn’t innovate, improve the good, or go out of his way to provide good service in its delivery. Why would he?
Medicare has both of these problems. For the consumer – the injured or sick person – Medicare is effectively free. I say “effectively” because it isn’t free at all, but the cost of it is unrelated to the use of it. The tax is taken whether anyone uses the program or not. This is the BYU situation. Might as well go to the game, because you already paid for the ticket. And in some situations, where an emergency room is seriously overcrowded, it is true that the cost in time you have to wait means that only really, really sick people are willing to stay there long enough to get seen, which self-selects for the genuinely sick and weeds out the hypochondriacs. But very rarely is the emergency room that crowded. Stories of people waiting three hours to see a doctor are common, but the actual incidence of that is rare, even in large inner-city hospitals that have huge populations of Medicare users.
The result of the “free” nature of Medicare is that it gets overconsumed. People use it that aren’t terribly sick. Worse, people use it to go to the emergency room instead of to the doctor, because emergency rooms have to see you, and doctors don’t. People show up in emergency rooms when they have earaches. The lack of a pricing mechanism for the care means that the patients take all they can. Heck, they’re not paying. At least, they’re paying the same amount no matter how much care they consume.
And for hospitals, it’s even worse. Medicare is a bizarre, complicated system that requires a lot of administrative staff to figure out. It is also spectacularly unprofitable to accept. Many services are compensated to the hospital below the actual cost (let’s forget for a moment that the hospital doesn’t know what anything actually costs) of providing the service. Hospitals lose money accepting Medicare, which means that they have to make it up somewhere. Guess where? Want to know why medical insurance costs are spiraling upward?
So Medicare is bad for patients, in that it encourages behavior that increases consumption of the most expensive care, and bad for hospitals, because it pays so much less than the cost of the care. It is a system that exists only because politicians believe – and we probably do, too – that if it didn’t, lots of truly sick people would die in painful ways, not having access to medical care. Personally, I think this is nonsense. But it’s a little hard to prove.
Next time, though, I’ll try to explain why Medicare is not insurance, what insurance actually is, and why it’s kind of unlikely that you have any, even if you think you do.
It’s not so much that a plucky group of huge overachievers threw everything they had at one of the bluest of blue athletic bloods, and came within one free throw, one rebound, one INCH of winning, as it is that that same thing happened to me twice in one night.
I coach a church boys team, mostly a collection of flotsam and jetsam: one player not quite 5′ tall that has never – not once – held the ball in his hands without either traveling or double-dribbling, because he’s never played basketball; one player 6’2″ and 280 that cannot really run, but instead shuffles through what will be the tenth game of his life; two players under 4’6″; and then, in the last minutes before the game, one of our best players, our best rebounder and only low-post player (despite being only 5’10″) is disqualified by the regional director and unable to play because he’s FOUR DAYS too old, and one of our other best players shows up with a broken right hand (he being right-handed). That youth team, that has never before in living memory won more than one game in a season, yesterday played against the best team we’ve played all year, a team with two players taller and far more skilled than anyone we have, and went right down to the wire in the regional tournament.
We played our full-court 1-3-1 defense, a defense we call “chaos”, because the only way we can win is if we create so much chaos on the floor that the other team can’t play anything like its regular game. We have to create enough havoc that Kyle, by far our best player, can steal the ball in the swirling wreck of the game and take it down and lay it in. We have no outside shooting. We made one three-pointer all season. We score off our defense, or we don’t score. So that’s what we did yesterday. It’s all we can do.
Kyle had a triple-double. He scored 24 points, had 13 rebounds, and FOURTEEN STEALS. My son Nicholas, with the injuries and suspensions now our second-best player, played like a champion. He penetrated, he rebounded, he drew fouls, he quarterbacked the defense. Also, he airballed freethrows and three pointers, but he gave everything. And in trying to do everything, he fouled, and eventually, he fouled out. He’s never given a better effort. No one could have played more all-out. My son Crispin, who has never been on a basketball team before, was a defensive force, ran until he wore through his shoes, and scored, for the first time this season, after hours of hard work in the gym learning to shoot layups. Our tallest player – the one playing his tenth-ever game – got rebounds. Our short kids penetrated and scored. They all played, collectively, the best they ever have. Every player threw his heart on the floor and did whatever he could to win.
And there was a chance, despite the talent gap. The other team had only six players. At halftime, three of them had three fouls. With 6 minutes left, one fouled out. With 3 minutes left, they were up by only six, when the ref blew his whistle and called traveling on our player instead of the reach-in on theirs, and that avoided them having to face our defense with their best player on the bench and only four players on the floor. Bang-bang play, could have been one or the other. That call just didn’t go our way.
With two minutes left, still down just six, with Nicholas on the bench fouled out, Kyle stole the ball and had a clear layup…and missed. We stole it again, and missed again. Two possessions later, we had FIVE offensive rebounds, missing point-blank shot after point-blank shot, so exhausted that we couldn’t even get the ball over the rim, but scrapping and clawing and doing whatever we could to win. It wasn’t enough. They were, in the end, too much for what we had. If everyone had been able to play, if they’d all been healthy, if one more call had gone our way, if Nicholas had been able to stay on the floor…if.
We were classy. We cheered the other guys. We shook their hands, and told them how well they played, and that we wanted them to win it all. We simply did our best, and it wasn’t good enough.
And then I went home and watched it happen again in the NCAAs, to Jimmer and my Cougars.
I’m so proud of my teams. They did their best under incredibly difficult circumstances, in situations where they shouldn’t have had any chance at all, and they showed that they were men of honor and grace, and grit and determination, if not necessarily skill. I could not be prouder of my sons, or my university. I would so love for them to have had another chance to show what they could do, if all the work they put in had resulted in just that little bit more that it would have taken to WIN.
But life isn’t a Disney film, and the battle really is to the strong, and the race to the swift, at least most of the time. The reason they make movies about the 1980 US hockey team and the little basketball team from Hickory High and Luke Skywalker banking in his torpedoes from miles away is that those things don’t happen very often; in fact, they’re so vanishingly rare that they take your breath away.
And my heart aches, because I want those things for the men and boys I love. I want them to have the rewards it seems to me that they deserve so richly. More, I want them to believe that it’s possible for hard work and team to beat height and money. I don’t want them to know what I know, that most of the time, the money wins. That God, for reasons of His own, sometimes seeth openly, and rewardeth in secret.
It’s a hard day, here. But we’re still working. What else, really, can we do? We’re not going to be tall. We’re not going to be rich. We’re never going to have U Florida’s money and we’re not going to have 6’2″ 13-year-old ballhandlers and people I love and care about are still going to get abused by their superiors’ thoughtlessness. As bad as we want to, we can’t fix any of that. All we can do is what we can do.
And in the end, we must do all we can do, because if we don’t, Jimmy Chitwood never will hit that final shot, and there never will be a Miracle on Ice, and the Death Star will blow up Yavin and kill Princess Leia. Because if we do not behave as if this time, THIS time, we can get all the way there, then we will live in a world in which the money and the power always win, where cheating is always rewarded, where there really isn’t any hope for those that don’t have advantages. And as unfair and capricious and mean as this world is, at least we can say that it isn’t always that way. Sometimes, Rudy really does go unblocked and get that sack. But he never does if he doesn’t blitz.
We are BYU. We are the mighty Lehi 9th. We are the PR department of City 1st, and the Lehi Rotary Club, and Heart-2-Home. We are the Clan Jones.
And because we are, we rise, and we shout. Still.
We are BYU.
Most of you know I teach a class every week on Scholarship and Leadership to a group of 13-17-year-olds. The class ranges all over; we study George Washington, Gandhi, Lincoln, and ourselves. There’s a lot of writing and thinking about how to be whatever it is we want to be. Today I got a question from one of my very favorite students about motivation, as in, how do I motivate myself? Apparently, she wasn’t all that keen on writing the last essay I asked for, and struggled to make herself do it.
Boy, do I know that feeling. But I had an answer.
Hmm. Motivation. Good question.
There are about a million different theories about how to motivate oneself. There’s meditation, there’s affirmations (where you say inspiring things to yourself in the mirror), there’s prayer (I’m partial to this one, though I admit it doesn’t always work), and then there’s the only one I subscribe to all the time, as it never fails – just suck it up and do it.
I read a lot of self-help books, looking for answers. The best one is, of course, the scriptures, but I like biographies of great men and women, and sometimes just inspiring fiction (Card’s books, Dick Francis, lots of others). I believe that the greatest motivating force in the world is love. I also believe that ultimately, that is the ONLY durable motivating force in the world, as all things shall fail, but charity (that is, love) never faileth.
But then there’s the problem you’ve already thought of: how do I love writing an essay? And the answer is, I have no idea. BUT. I do know that you love the class. I know that you love the idea of doing great things, of being the kind of person that your children will admire and emulate, and that a good man will love and cherish. I know that you love being disciplined, and doing hard things well. When you’re in your right mind – you know what this means – you love these things. When it gets hard to write and to read, when you just don’t have any interest in doing what you have accepted the responsibility to do, that is when you have to have faith that when you made the commitment you DID know what you were doing, and that you do want the things you’ll get if you finish.
And then you just sit down (or stand up, whatever) and do what you have to do. There is no job, no task, no activity, that you’re always going to want to do. Nothing. I swear to you, there is never going to be anything that you don’t loathe at some point. But adults, real adults, they do those things even when they can’t stand to do them. It’s what gets Mom up in the middle of the night to clean up puke. It’s what takes Dad out the door in a snowstorm to go to work. It’s what makes me grade essays when I have three clients calling me wanting status updates on their loans. It’s what makes me call those clients back at 8pm, because I’m still at the office because I was grading essays.
I have a quote above my desk (I have several, but this one is pertinent). It says “suck it up and call”. That’s what I do. I call people. I hate it. But that’s what I do because I love the things I get if I do it. Some days, it’s close. Heck, some days, the hate wins. But not every day. Not most days. More and more, it’s ME that wins, the real me, that knows how to shoulder responsibility and loves the strain of hard work. This will be true for you, I promise you.
Just keep going. Grit your teeth, and move.
You can do it.
Apropos of this, I’ve written before on how silly – and at points destructive – the modern psychobabble is about “following your Muse” and “doing what you love”. Don’t misunderstand. As a man with an active Muse himself, I listen to those whisperings a lot, and I don’t think that’s a bad thing. But there are days when the Muse tells me to write my novel, and I don’t get to do that, because I made other promises. It’s hard, but that’s part of being an adult. My Muse is fascinating and romantic, but she isn’t smart, and she’s definitely not wise.
Old-fashioned virtues, no doubt. But critically important ones. All of modern society points us at the carefree and romantic as the only ways to really “live”. Fortunately, there are enough people left in the world that can see that is nonsense that some things still get done. There are those that don’t cheat on their spouses, even when the Muse is telling them how hot their secretary is. There are those that shoulder a pack and a rifle and slog through the mud to get shot at. Thank a Merciful God.
I don’t believe that I was put here to find what I love to do and do it. I think I was put here to find what I should do and learn to love doing that.
I love poetry. But it is prose that makes the world go ’round.
Gabriel’s rash is mostly better, but now he has fascinating blisters down the front of his cast that we can’t see any cause for. The cast is wet, though we dry it as best we can (it doesn’t get dried much when I work late, which I’m having to do more and more often now), so I’m sure that has something to do with it, but what can we do about it?
Still no bill from the ambulance. Is it mentally unstable of me to hope that they’ll forget?
There’s discussion by some people of having a family dance/fundraiser to defray some of the Gabriel expenses. Is that something that would be of interest? Who would come to that?
Next post is the long-promised “why I don’t believe in Medicare” one.