My Friend’s Medical Bills

Talk about your boring blog topics—it doesn’t get worse than—health insurance. But the subject came up this morning with my friend. I will do my best to make this interesting. I will do so with plenty of sarcasm and wisecracks, no doubt, but don’t confuse that with flippancy. This is a deadly serious topic for my friend.

Thankfully, she has great insurance. She is covered under her husband’s generous plan through his employer. So far, her cancer ordeal has cost her only the total of her maximum out of pocket limit which is absurdly low! Her plan runs from June to June, so at the end of May she will be on the hook for another out of pocket limit. But again, it is a small and very manageable number. Everything else will be paid by her insurance company, permanently taking her off their Christmas card list.

So far, she has been battling this nightmare for just over five months. There have been tons of doctor’s visits, six chemo treatments and a seemingly endless parade of medications to help her deal with its effects. But, there hasn’t been any surgery or extended hospitalizations. When she told me the total price tag so far I was mortified. $600,000...and she hasn’t even had surgery yet! Just imagine how much an eight hour surgical procedure will run, not to mention the six additional weeks of radiation. Worst case scenario would include an additional year of chemo. My mathematical skills aren’t what you would call elite, but just some entry level extrapolation makes it clear that this thing might end up costing over two million dollars. Let me write that out for you. $2,000,000. That’s ten Lamborghini’s. That’s three lake houses in Maine. With two million dollars you could buy enough sausage to feed everyone in Pittsburgh for a year. While it’s certainly true that you can’t place a monetary value on a human life, two million clams is still a lot of money.

Is it worth it? What kind of utilitarian nonsense question is that? Of course it’s worth it. But, suppose my friend didn’t have health insurance? Or suppose she had accidentally let it lapse because she forgot to pay the premium? Suppose her husband’s employer decided to stop providing subsidized insurance to their employees?  Suppose he got laid off and couldn’t afford the Cobra premiums? Thankfully, none of these things happened and my friend is mercifully shielded from the financial death that enduring this would surely bring without health insurance. But what about those not so fortunate?

I would imagine that the only thing worse than going through a life and death cancer war would be going through a life and death cancer war...without health insurance. 

As most of you know, I have had a life long aversion to and suspicion of powerful, centralized government. Second only to my aversion and suspicion of big government has been my aversion to and suspicion of big business. In this country there is no business bigger than health insurance. So I am in a classic bind on the subject of government run health insurance. Should we leave the frying pan of profit driven big business-run care for the fire of government bureaucrat-run care? Should we trade in the bean counting accountants at Anthem for the paper pushing apparatchiks at the Department of Health and Human Services? Would you rather have to deal with the soulless money grubbers at the insurance company or DMV style morons? It is a vexing questions with no good answers. But when I hear of $600,000 chemo bills I start to wonder...is it even possible for government run health care to be any worse? At least with the government nobody would have to declare bankruptcy after getting a cancer diagnosis. The country might go bankrupt...but we could cross that bridge when we get to it.

One more thing. I just got my Anthem bill in the mail. I got my annual rate increase. It wasn’t horrible...only went up 7%. So starting next month i will be paying $1458 a month for a $3500 deductible plan for the two of us. Add to that the $400 a month I will deposit in my Health Savings Account to cover that deductible and you’re talking over $22,000 of my income after taxes goes to insure that I won’t be bankrupted by an unexpected diagnosis.

Something is extraordinarily screwed up about that. Don’t you think?

Good Luck, Kids

Ordinarily, I would say that there isn’t anything in the universe that I care less about than the British Royal Family. I fully understand that this view places me in the minority in my country, not to mention my own family. Around here any royal wedding is must see TV. My sister is a lifelong Anglophile. I like England well enough but my view essentially has always been...You guys are fine, but your monarchy is silly and pretentious and...oh yeah...we kicked your ass 240 years ago to prove it.

But this week comes news that these kids have had enough and are actually trying to quit the royal family!

Apparently they are sick and tired of living in the bubble of British tabloid scrutiny. I guess they’ve had it up to here with ribbon cutting photo opps and the most overbearing and powerful mother in law in the history of civilization. No doubt, the Queen is royally pissed. My first reaction to this news was...Wow. Good for them! It takes some guts to give the finger to the House of Windsor. But, it was inevitable really. There was no way an American girl was going to put up that foolishness for long. The red-haired guy should have known that from the get go. I mean, just look at her...can you imagine her walking around a castle wearing white gloves and stupid hats all day?

First reports were of a planned move to Canada. Perfect. Then word came that Harry was looking for work now that their royal allowance was getting cut off. Another good idea. But then the news turned troubling. It was learned that they might be headed to Hollywood. No, no no no. You don’t exchange one out of touch, entitled fantasy world for another! Then even worse news...the ex-royal couple were being advised by that noted down to earth everywoman...Oprah. Frying pan? Meet fire.

It remains to be seen how this all plays out. I hope they are able to create a better life for themselves. I really do. But when Vegas posts odds on how long their marriage lasts post royal family, over or under five years....I’m taking the under.

My New Normal

Agenda Items For Today, January 8, 2020...

1. Attend to swollen and puffy eye with Benadryl and cold compress

2. Stand in freezing cold on my deck in my pajamas while waiting for neurotic dog to relieve herself

3. Try to comprehend vagaries of the human experience that cause the S&P futures to go from down 400 to up 60 literally overnight.

4. Make an appearance at Bennett Funeral Home to show respect for long time friend’s deceased mother.

5. Drop by hospital to visit long time friend who just underwent quadruple bypass operation.

6. Design new investment strategy for dear client who has been informed that he only has two years to live due to incurable bone cancer.

7. Meet with two clients for annual reviews.

8. Submit complicated and corrected paperwork to change ownership and beneficiaries of the vast holdings of client who passed away late last year, including Power of Attorney documentation since surviving spouse is incapacitated with Alzheimer’s.

9. Go to gym for workout to fight suddenly ballooning weight.

....Welcome to life in your sixties.

Friend Update

My courageous friend is finally finished her three months of chemo. From my perspective it has been like watching a horror film, one grisly scene a day, a Chinese water torture of agony. But each day she answers the bell with an optimism and gratitude that at times borders on the miraculous. Sometimes I want her to just scream and cry and lash out at the unfairness of it all. That’s what I would do after the third of fourth trip to the bathroom, three days after my first treatment. But not my friend. After three excruciatingly difficult months of this poison she still throws around words like thankful and grateful. Instead of bitterness and anger, she speaks of counting her blessings.

This is not to suggest that she hasn’t had her moments of despair. How could she not? But they have been rare, quickly overcome with a dignified determination to overcome. “I’m sorry, but this morning I feel like a whiny baby,” she offers by way of explanation for her rare lapses into anger, actually apologizing to me for her ill temper. I just shake my head in amazement.

Next up is surgery at the end of the month. Further treatment plans will be dependent upon the results of that surgery. In the meantime, the chemo is over with, a major hurdle endured and overcome.

As we enter the fourth month of our daily morning conversations, my inventory of dad jokes has been throughly depleted. I have been scraping the bottom of the barrel of late with some truly pathetic stuff, like these beauties:

My friend Jack claims he can communicate with vegetables.

Jack and the beans talk...

What do you call a sheep who has been dipped in chocolate?

A Hershey baaaaaaaa.

Did you hear that over a thousand dollars worth of Viagra was stollen from the CVS yesterday?

The police are looking for hardened criminals.

The fact that she still laughs has me worried that the chemo may have warped her sense of humor. Either the chemo or continuous exposure to my material. Regardless, yet more collateral damage!

So, if you are reading this, say a prayer for my friend today. And if you are cancer free, add a prayer of thanks.

Time To Saddle Up

Like many of you, my professional life has been in limbo since roughly the 20th of December. Sure, I’ve been into the office on several occasions since that last Friday before Christmas, but not an awful lot of serious work has gotten done since the beginning of the Holiday Season. That all ends this morning. I will trudge in early, put on a pot of coffee and gird my loins for my 38th year in my chosen profession.

2020 will be like most of the previous ten years or so. From January through the end of May I will cram my schedule full of appointments with clients, one annual review after another. I will meet with them, go over their accounts, access their results, update their risk tolerances and suggest any changes that might be appropriate. When I walk out to the reception area to greet them I will immediately notice when one of them is ill. It happens almost every year, at least once. In the 12 months since I have seen him or her, they’ve gotten sick. I can see it in their eyes. It always stops me short. It is a disturbing thing to be confronted by the relentless pursuit of mortality.

By May 31st I will have grown extremely tired of the sound of my own voice. At least once during this five months of frenzied activity I will loose my voice entirely. It will occur to me more than once that I probably should space these reviews out over the entire year instead of front-loading them into the first five months. But, I will remind myself that there is a method to this madness. By doing 70% of my year’s work in the first five months of the year, I free myself up for a summer and early fall full of...Maine. This year there will be two trips, the entire month of July and two, hopefully three weeks in late September, early October. Once I have scratched my Maine itch, I will return for two more intense months of client meetings, then things will slow down again over the holidays. I have used this strategy for several years now and am happy with it, my attempt to achieve the much ballyhooed life-work balance that all the smart kids are talking about. The plus side is that I get to recharge the batteries and step away from the incessant pressure of this business for an extended period of time every year. The down side is...I walk away from a lot of money. As a business owner, I am afforded no “vacation pay.” Time spent away means that productive activities are placed on hold. No work? No new business gets done. Luckily, I have a cracker-jack assistant who keeps the place from catching on fire while I’m away. 

Is the money I lose worth the time I’m away? It’s a fair question for which I have an unequivocal answer...Yes...a thousand times YES.

I do not live to work. The end goal of my life is not the accumulation of wealth or the illusion of safety. I have learned through hard lessons that all of this could be over tomorrow. I am one car wreck, one shadowy x-ray away from losing everything...and so are you. I don’t dwell on this hard truth. If I did I would be miserable. But I do keep the tenuous nature of this life in mind when I make my plans. Ultimately, I work to live and find ways to serve. I battle to keep my eyes and energies focused on the eternal, not the temporal. That’s not always easy, but each year I get better at it.

So, this morning it’s time to saddle up. July will be here before I know it!

A Word About Our Troops

Over the past few days I’ve seen the pictures on television and the internet, long lines of young men and women in dusty brown fatigues loaded down with fifty pounds of gear, marching across tarmacs, climbing into those enormous C17 transport airplanes. There are no military bands playing, no crowds of well-wishers sending them off, just a long line of twenty year olds who volunteered for the job of going to war.

I am always stirred by the sight. Who are these men and women? What possesses them to sign up for such duty? Who do they leave behind? How many will never come back? I am stirred because I am proud of their courage. I am stirred because so many of my ancestors were in the military. And yes...I am stirred because I am a patriot. I love my Country and when I see long lines of troops being deployed I know that we are sending the best men and women we have to offer. But I also know that most of us will forget about them in a week or so once the football playoffs get going. They will fall out of the headlines in our newspapers. Once again it will be impeachment news or campaign coverage. So, while the feelings are tender, I write.

But there is another emotion besides pride that rises in me when I see these long intrepid lines. Sadness. My patriotism is always tempered by sadness. I love them. I’m proud of their devotion and willingness to fight our battles...but why do we keep asking them to do this? Why do we insist on sending thousands of them, year after year, to the same hellish place? Why is every fight our fight?

Our military exists to fight, to attack and defend, to break things and kill people. I fully understand their mission. But what is the existential threat that requires them to give the last full measure of their devotion...in Iraq? Tribal, barbaric, eternally dysfunctional...Iraq? 

When we lost 50,000 men fighting Nazi Germany we all understood that the sacrifice was worth it. When this nation lost nearly 600,000 Americans fighting the Civil War, the cause was just. But what of the modern Middle East? Our Allies are despicable authoritarian regimes (Saudi Arabia). We are killing horrible men with dangerous intentions. But other horrible men rise up like mushrooms after a week of rain as their replacements. They attack our embassy somewhere, a garrison somewhere and we have to respond. Then the cycle continues for what feels like eternity. Why is it that they always attack us? Mostly, because we are every where they look. Our presence in that part of the world is ubiquitous. We are the target because we choose to be. As the world’s policeman, we insist on having a precinct in every God-forsaken neighborhood on the planet. What do we get for all of this police work? Long solemn lines of men and women in dusty brown fatigues, loaded down with fifty pounds of gear climbing into C17 transport planes...and a lump in our throats.

Yes, we pray for them. But perhaps we should also pray for our civilian leadership as well, that at long last there will arise in the halls of  power...wisdom and sound judgment worthy of our military’s courage and devotion.

No Stupid Wars

So, a few days ago a mob of Pro-Iranian protestors attacked the American Embassy in Baghdad, Iraq, this in retaliation for an American military attack on a group of Pro-Iranian fighters in Iraq. Today comes news that the United States has retaliated by unleashing the American military to assassinate the second most powerful man in Iran, a general with a menacing glare named  Soleimani. Now, the Iranian government is issuing threats of massive and relentless retaliation. In other words, absolutely nothing has changed in the Middle East in the 61 years I have been alive on Planet Earth. It is the place where endless retaliation is a reality of daily life, a place where every President in my lifetime has gone searching for a Nobel Prize. It is also a place where American military personnel have been fighting and dying non-stop for the past fifty years. I am told by sophisticated people that we have no choice. American leadership in the Middle East and our participation in the never ending peace process is critical for stability in the region, that if we were to wash our hands of the place it would leave a power vacuum which our enemies, presumably the Russians or the Chinese would be more than happy to exploit. If I persist in arguing otherwise I am dismissed as an isolationist, which I am assured is a terrible thing to be.

Thirty years ago, it was hard to overcome the argument that getting out of the Middle East would jeopardize access to the world’s oil supply. Today, the United States is a net exporter of oil. Forty years ago we were told that our alliance with the State of Israel was not only part of a divine edict from scripture, but crucial to that besieged country’s survival. Today there are twice as many Jewish people living in the United States than there are living in the State of Israel. Meanwhile the Jewish military is routinely ranked among the most powerful and sophisticated units in the world. Past attempts by her enemies at invasion have been embarrassing and disastrous failures. Yet, still, American foreign policy remains firmly committed to an unending military presence in the Middle East and an undimmed determination to support the foreign policy and military goals of the Jewish State. Which brings us to the current President of the United States.

One of the few items of Mr. Trump’s policy agenda that I was on board with back in 2016 was his oft repeated slogan...No Stupid Wars. Moreover, on more than one occasion on the campaign trail, he looked straight into the eyes of the empire wing of NeoCons and flatly declared that the days of endless Middle East wars was over. Now, this.

Donald Trump certainly wouldn’t be the first President to lob a few missiles when in trouble domestically, wagging the dog being a thoroughly bipartisan enterprise, but if he were to do so now, he will have to eat a very bland diet of his own Tweets accusing Barack Obama of doing the exact same thing. Perhaps this missile attack on the Iranian general will be a one off and the routine bluster from the Iranian Government will prove to be just that...bluster. But if not, if we are now once again headed straight for another hot war in the Middle East, somebody please explain to me why we would not want to hand this job off to our enemies?? Let the Russians get bogged down in this quagmire for the next thirty years or so. I can’t think of an authoritative government anywhere who deserves to spend the next thirty years dealing with the hell-hole that is the Middle East more than the Chinese Communists. If either of them would like to fill the void that us leaving would create, I say, let them have it. If they want, we could even throw in the Korean Peninsula in the bargain. Once divested of the headache that is Arab-Israeli conflict the United States could save enough money to balance our budget. We would have enough time and energy left over to cure cancer, figure out health care, provide high speed, low cost internet access to everyone and figure out a way to run the DMV more efficiently. This new foreign policy would even have a name...Instead of “Making the World Safe For Democracy” or The War To End All Wars” or even “Containment”...this new thing would be AMOOB...

America Minding Our Own Business.