If you should ever find yourself thinking that you know everything there is to know about a given part of our healthcare system, please, think again.
Think again because, at that very point in time, just when you least expect it and are at your ultra-hubristic max, you just might find yourself — d’oh! – the subject of one great-big healthcare-system-comeuppance. And if, in spite of this admonition from me, you nevertheless choose to go forth, plowing on, fully forward fast, thinking that you’ve got it down cold and nice ‘n pat, then please picture yourself hanging upside down, one foot in a fully-tightened jungle lasso, slowly twisting and gently bouncing, helpless and vulnerable and incapable of making things right, because you, my friend, just stepped into a healthcare system trap for the unwary.
(Sometimes we must give thanks to lawyers everywhere for coming up with great phrases; I believe this to be one of those phrases and therefore one of those occasions, so thank you lawyers for this wonderful trap for the unwary gem of an encapsulating phrase.)
One of the more amazing traps for the unwary making news these days occurs when a person on Medicare (generally, a U.S. citizen or permanent resident age 65 or older who’s also eligible for Social Security retirement benefits) is in the hospital but not, ya know, in the hospital. And being in the hospital but not, ya know, in the hospital, can change what you might know as that person’s hundred days — yes, for those who’ve been there, I’m talking about that hundred days — changing it from being a marvel of American ingenuity and care-free, smooth-running healthcare delivery into a nightmare of a financial shellacking and foregone though much-needed healthcare.
Allow me to explain . . .
Making the blogosphere rounds this past week was a very interesting article by Anya Schiffrin.
The article compares what it’s like having stage 4 pancreatic cancer in the U.S. healthcare system vs. what it’s like having stage 4 pancreatic cancer in the French healthcare system (for those who always have to think about what cancer stages mean, the higher the stage, the worse the medical condition, so stage 4 pancreatic cancer is the worst stage of one of the worst kinds of cancer).
Ms. Schiffrin knows of what she speaks, because throughout much of 2013, her father, Andre Schiffrin, received chemotherapy treatment for stage 4 pancreatic cancer in both Manhattan and Paris, and, as is the loving baby-boomer-child’s wont, Ms. Schiffrin was directly involved in helping her parents deal with the nuts ‘n bolts and the comings n’ goings and the whatnots ‘n wherefores of that whole thing. So the Schiffrin family was conducting, by happenstance, something akin to a controlled experiment, as seen through the eyes of a terminally ill patient and his family.
Here is a triplet of paragraphs from Ms. Schiffrin’s piece that well-summarizes the jarring differences between the two systems: …more ►Wednesday, February 12, 2014 at 7am
How many people do you know who truly love their work? My hunch is that your answer to that question is, at most, something in the neighborhood of “oh, maybe a few.”
And of those few, how many do you think would continue in their work if they had some million of dollars stored up, floating their boat, and knew with 100% certitude that those dollars were enough to last them a lifetime, even if they lived to be a hundred and fifty? My hunch is that your answer to this question would now be something in the neighborhood of “oh, quite probably not a single one of ‘em.”
So let’s assume that most people work because they have to work — that they have to work because they have to make a living.
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Now, contrary to some numbskull sort of logic, by no means is this most-people-work-because-they-have-to-make-a-living idea tantamount to saying that people don’t find value in being productive, or that they’re lazy. To the contrary, as best I can tell, just about everyone feels at least a bit off-kilter, and some people just fall to pieces entirely, when they’re not endeavoring in one way or another. After all, even stone-cold slackers come to know, at some point, perhaps later rather than sooner but eventually, that stone-cold slacking is not all there is to life, my friend.
This concept comes up often enough in my work with clients that I’ve come to encapsulate it within the phrase fish gotta swim. So, just as fish gotta swim, you, I suspect, gotta do something that you find productive — something that feels worthwhile, something that helps you feel good about yourself, something that naturally finds your internal self just a’whistlin’ a happy tune just because. I in turn encapsulate this concept within the phrase worthwhile endeavoring, to connote that, yes, it’s doing that we’re talking about here, but, yes again, it’s doing that, for you, constitutes something much more than merely doing. And, yes yes yes, I s’pose you can also think of this in terms of self-actualization and the like, but I much prefer to make up my own lingo, ya know?
So, just as fish gotta swim, you, I suspect, gotta do something that, at its core, has an element, hopefully major, of worthwhile endeavoring. And if you don’t, why, then, pretty soon you just might find yourself — your entire self — feeling detached from something important, at which point you might feel like a big ol’ bump on a log, just takin’ up space and killin’ time.
For most people, then, making a living and pursing their worthwhile endeavoring are the two birds that hopefully one stone — their job — doth simultaneously check off.
And so it behooves all of us to be making our livings via something that is also a just-right-for-us sort of worthwhile endeavoring — something that approaches the perfect swim for each of us particular fishies, so that we can happily be productive all the live long day — rather than making a living doing something that finds us biding our time while we work, so that we can rush home afterwards to do the swimming we needs to be doing.
There is a righteous conjunction, then, where making a living and worthwhile endeavoring can come together for each of us.
The problem is, though, that it’s hard — very hard – for most of us to find that conjunction; that’s what the questions in the first paragraph above were all about. So it makes sense that we as a society should do our best to make it possible for more folks to find their ways ever-closer to these sorts of conjunctions, yes? Because the more we can structure our economic system to allow these conjunctions to flourish as deeply and as widely as possible, the more happiness among the all the little swimming fishies – us – there will be, and, with that result, the more evolved and beautifully-designed will our economic system also be, right?
For our economic system would then be a vastly improved system for allocating our most precious, most unique, most oft-wasted natural resource: our human capital. …more ►Wednesday, January 22, 2014 at 1pm
Ever since it happened last Sunday, Richard Sherman’s interview with Erin Andrews immediately following the 49ers/Seahawks NFC championship game has truly lit up the TwitterVerse. Some are applauding the authenticity of the moment, comparing it favorably to the vapid platitudes of most sports interviews. Others are berating Sherman for a lack of class and doing so in a way which, to many ears, smacks of racist dog whistle.
I, for one, found the whole thing unsettling, and it’s taken me a couple of days to figure out why.
Full disclosure: I live in San Francisco and would’ve loved to have seen the 49ers going to the Superbowl.
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I’m a carnivore. I eat meat. I cannot, however, look at images or videos of animals anywhere even remotely close to the process through which they become meat. So I’m OK with eating meat, but, please lord, do not make me confront the lives and deaths — most of them horrific — that these animals confront to satiate our appetites.
This idea, it seems to me, has very much in common with the commotion Mr Sherman’s interview hath wrought. Please read on. …more ►Tuesday, January 14, 2014 at 2pm
T’is the time of year when the financial media outlets — both lay and professional — are chock-full of stories about what 2014 will bring.
Should you listen to them?
I’ll start off with a blanket response to that question of nyet, and soften it only if you promise to gird yourself against powerful forces for financial ill-health, head-faking you with promises of prescience, but ultimately amounting to nothing more substantively noteworthy than a two-year-old correctly calling heads three coin-flips out of five.
My reasoning here is two-fold, paralleling the two main parts of this piece that follow below. First, most predictors’ predictions are not even worth the electrons we use to store them because the types of predictions that predictors most often get right are predictions that most of us could get right on our own without any help from experts, and, second, when predictions are brought into the financial context, they are used primarily as sales tools, to get you to do something you might not otherwise do, because, hey, if this guy/gal purports to be able to predict the future, what else might s/he be able to do for you right here in the present?
To follow the thread of these two ideas, from predictors predicting badly to predictors generating revenue handsomely, please do read on, and I’ll do my best to provide you with some thoughts quite a bit more useful than useless. …more ►