Thursday, August 31, 2017

Flatback Caper, Fairport Convention

This is from the LP pictured here, "Full House." I bought this album at the time, and I believe that most of my friends thought that I had gone mad.

But for the young rock and roller, what's not to like? The music is mostly very upbeat; the beats are all prominent, and bright; the players are all accurate and fluid; the entire proceeding is a big musical success, and wildly entertaining. Out of my usual genre at the time, surely, but somehow right up my alley.

If your wife objects to Nirvana at dinner time, or the Transplants, or even the Dandy Warhols, give this LP a try and see what she says. She might say, "what? did they change your meds?" Or then again, she might think that it was a very considerate choice. See what happens! It's an experiment.

Wednesday, August 30, 2017

An Entirely Remarkable Story About Thailand

Interesting things happen to me every day in Bangkok, and remarkable things happen on a regular basis. I don’t write-up every separate occurrence. This story, however, is awesome for several reasons. In two completely different ways it illustrates the deep, wide river of goodness that runs through Thai culture.

A friend and I took a cab ride yesterday from my campus to the Mall Bangkapi. This is a ride that I have taken hundreds of times by now. It takes about twelve minutes. Generally I love to talk to the drivers, and I learn a lot from those conversations. This fellow yesterday seemed like the quiet type, though, and I usually leave them to their meditations if that appears to be their style. I spoke a bit with my friend, the usual combination of mostly English with a little Thai, and we let the fellow just drive.

Within a couple of minutes I noticed that in the door panels in the back  there were bottles of drinking water, two on the right and two on the left. They were new, not refills. They still had the plastic around the tops. This was very unusual. I casually looked up front and the driver had a couple of refill bottles up there for himself. It was obvious that the new bottles were there for customers’ use and convenience, if needed. I didn’t think that I had ever seen this before, and it made an impression on me. It also reminded me of a similar custom that I had observed in the north of Thailand.

I spent three years living in the province of Phrae, way up in the mountains. It was two years as a Peace Corps volunteer, and one year on my own teaching high school English. I noticed early on that many of the houses had water bottles outside of the gates, which seemed a curious thing. When I asked a Thai friend about it, she explained that it was a northern custom to leave water outside for travelers. Many people walk long distances, and Thailand is a hot country. If one of the walkers gets thirsty, the water is there for them, and they can just help themselves. It seemed to me that the water bottles in the taxi mirrored this brotherly consideration for the needs of others. So I asked the driver about it.

“Excuse me,” I asked the driver (in Thai), “may I ask you? Are you from a northern province?” “Ah, yes, I’m from Sukhothai.” He seemed surprised at this question coming from a Farang, especially since I had guessed correctly that he was from the north. I told him about my Phrae experience and the custom with the water, and he told me that they do that in Sukhothai as well. "You putting this water in your cab made me think of that." I don’t think he had ever really made the connection to why he left water in the cab, and he had a good laugh when he realized that they seemed to be related events. We then had a nice conversation about brotherhood and community, and the wisdom of people helping one another. We got to the mall, and I gave him what in Thailand is a very good tip (35%). “You’re a good man,” I said, “very nice to talk to you!” He laughed out loud again, and that was that.

Or so it would seem, anyway.

At the mall, I went to the Dunkin Donuts to have a coffee with a Farang friend of mine, and my Thai friend went to do a little shopping on her own. After an hour or so she came to the Dunkin and said, “I have a problem!”

She had left her phone in the cab. She told a confused story about going to the “PR” at the mall, somebody called somebody, and the driver was on his way back to the mall with the phone. It seemed to be a dubious proposition, because considerable time had elapsed and we had no taxi number, no drivers’ license number, or any other information about the cab, but who knows? Maybe it’ll work. I talked it over with my Farang friend and I decided that 300 Baht ($10) would be a fair reward for such a thing. Thai people usually don’t think about tips or rewards. My friend went outside to wait at the taxi line, which we could see from the Dunkin.

Sure enough, the taxi returned, and after a brief exchange my friend came back in waving the phone and smiling from ear to ear. It was just a mid-line WuaWai, but still worth about $175 new (replacement value). The driver had seen the phone and thrown it onto the seat next to him while he took a couple of other rides.

The “PR” turned out to be "public relations," the customer service office of the mall. They had the phone number for “lost and found” in Bangkok taxis, but that service couldn’t help without any information. Then they tried calling the phone itself, and the taxi driver answered it! He remembered us, of course. After that conversation that we’d had he would remember us for at least six months, and tell his friends the story over drinks. He said, sure, I’ll come back now. My friend said, “turn the meter on,” and the guy had another good laugh about that. Meter, schmeeter, I’ll be right there. It had taken him almost half an hour to return to the mall, with the meter off, not expecting a nickel.  Having 300 Baht forced on him was the funniest thing he’d ever heard.

Bear in mind that the driver could easily have sold the phone for about sixty bucks. Bangkok is full of places of all sizes selling used phones, and they will buy a working phone for about half of what they can sell it for. This phone, in its present condition, would sell for about 4,000 Baht (that’s $120). Over here, you can buy a used phone, buy a new SIM card and phone number for two dollars, and take it to a service provider to set up an account right away. Very easy.

I don’t know about you, but to me that qualifies as an altogether remarkable story, in all of its particulars. I love it when people ask me, “Fred, do you feel safe in Thailand?” Why yes, I tell them, I do feel safe. No place on earth is perfect, but Thais can be so cooperative and hospitable that it’s almost enough to restore your confidence in human nature. These days, I can use a bit of reminding from time to time that some things, somewhere, are still going very well. 

Saturday, August 26, 2017

The Epic of Gilgamesh: With A Guest Appearance By One Of My Professors

I just watched this lecture, and it was a rocking good time, I must say. Gilgamesh and Enkidu were a pair of hell-raising, head-turning MFs around 4,000 years ago back in Babylonia way. It was all very nice, but along the way I got a considerable shock. I knew one of the professors featured in the video.

Dr. Irene Winter is one of the three commenting professors at the end of the lecture. She shows up at 1:18 in the time counter. I took a class that she taught at Queens College of the City University of New York in 1973 called "Art of the Ancient Near East." (My undergraduate degree is in Art History, from Queens.) She was at Queens from 1971 to 1976. After that she moved around a couple of times before coming to rest at Harvard, where she has been a so-and-so Emerita Professor of Archaeology for some time now.

It's nice to see that she has made a success of academia, which is a very tough nut to crack. Listening to her speak on this video it is easy to recall her voice as a very beautiful and very enthusiastic young professor in the early 1970s. She was born in 1940, so when she taught my class she was only thirty-three-years-old, and I can tell you that she was really something. She was vivacious and charming, ridiculously lucid, and the brightest light in any room at all.

By that time she had been studying and traveling around the Middle East for some time, and she had a very interesting wardrobe, featuring vests and jackets and accessories from Libya to Afghanistan. Many people are shy to wear that kind of thing, but she wasn't shy about it at all. All very tastefully done, she'd wear one item at a time in combination with other more conventional items of  subdued colors, like earth tones or grays.

She's eight years older than me, which makes her seventy-seven this year. The video seems very recent, from mentions of ISIS in the city of Mosel in Iraq. I think that she looks and sounds great, and it sure was great to see her after all of this time. Good luck, Professor Winter, and God bless. Your success is a blessing to me, and I appreciate the gift.

Internet Comments Are Boss

The Internet! We all love it. It’s the one thing that we can all agree on. One of my favorite aspects of the Internet is that there are comments attached to most things. These comments can be a real education for anyone interested in the psyche of Twenty-First Century Americans.

“Allen West Exposes Reason For USS McCain Crash”

“I can’t believe that traitor has a ship named after him.”
(This error was immediately rectified by helpful comments from people who pointed out that the ship is named after the other two John Sydney McCains.)

“Yeah, let an illegal niqqr be POTUS. Everyone that supported and voted for Barrak should be shot as traitors.”
(Is that spelling to get around YouTube rules that are meant to encourage civility? They don’t work as well as planned.)

S-A-B-A-T-A-G-E,… did I spell it right?....
(Next time try typing in the word just to find out that it should be sabotage. Auto Correct is evil, but Spell Check can be your friend.)

james williams
“I hope I live long enough to see Obama dead.”
(Many people write things like this under what may be their own names.)

Harris Anne
“Rename it the USS RONALD REAGAN.”
(There already is a USS Ronald Reagan.)

Exposing the Darkness with the Light of Truth
(Mr. or Ms Exposing the Darkness with the Light of Truth has a lot to learn about click-bait.)

“I’m wondering if Russia and China don’t have new radar blocking capabilities slowing them to go undetected in air and sea.”
(And a Harry Potter Cloak of Invisibility, too. Thanks, Autocorrect, for adding a nice touch.)

“mccain should be stricken from the records like he never existed & obama & the clintons &&&&”
(Lots of hate here for Senator McCain. Long time readers will recall that I hated him before it was popular.)

Joseph N. Pollaro
“McMasters is the cause – he is a deep state traitor, lock him up.”
(I did not see this one coming.)

“crash McCain was in charge, that’s why.”
(Lots of name confusion, too. That’s what happens when families use the same names over and over. It’s hell on the insurance companies. “. . . to John Sidney McCain, but if John Sidney McCain predeceases me, then to John Sidney McCain.”)

joe s
“Blame the total POS Obummer, aren’t you dimwits glad you voted for the KOOL guy? What a bunch of moon bats.”
(Allen West draws a very anti-Obama crowd.)

william mize
“Can you say Mia he was no guest of who? Vitnamese snipes wow”
(I think that I know where he was going with this, before he got lost.)

Stevo Reno
“Video gamer’s running (running a-ground) real war ships……..Men & women & trannies and all getting it on (on deck)”
(Stevo has obviously considered this problem in detail.)

Steve Carlson
“There weren’t enough shemales, gays, women and of course lesbos aboard her. Too many men. We need more diversity and perversity you know.”
(Steve goes to the same church as Stevo Reno.)

“Obama did everything he could to destroy the military. He almost did. Thank God for Trump.”
(It’s August 26, 2017. You don’t see as many “Thank God for Trump” comments as you did six months ago.)

Roudy One
“china and russia are hacking our satellite guidance systems with russian and chinese satellites  easy to see:\”
(It’s very interesting that the words “Russia and China” seem to come out in one breathe among the paranoid classes.)

Charlie K
“There is a man who is calling a spade a spade.”
(And the man himself is a spade! Charlie missed a great chance to say, “there is a spade who is calling a spade a spade.”)

Robert Garrison
“They are using a localized EMP weapon. Not hacking.”
(I enjoy the rhythm of the hacking/EMP idea, but orchestrating the hacking and the crash at sea would be a huge challenge.)

Seeker After Knowledge
“This is hate wing nut bullshit.”
(Thank you, Seeker After Knowledge, for getting right to the point.)

Internet comments are always fun. This particular thread is refreshingly light on the ad hominem attacks, but the anti-Obama thing is still going strong. I was surprised at the level of obloquy directed at McCain, who is a white Republican with good PR over the years. I guess nobody is safe anymore.  

Thursday, August 24, 2017

The Five Du-Tones - Shake a Tail Feather

Here's another classic in the same vein as the Flares and the Volumes (below).

The Van Winkle Routine

Help me out here. I must have been dreaming. I’m pretty sure that when I went to sleep Donald Trump was considered by most Americans to be a rich-kid asshole with poor grammar; bad taste; multiple behavior problems; bad dresser; business failure; weird hair; no manners; borderline con-man; comedy TV actor staring in a show about a rich-kid asshole. Now I wake up and YOU EXPECT ME TO FUCKING BELIEVE THAT DONALD TRUMP IS THE PRESIDENT OF THE UNITED STATES?

And that’s the United States of America? Are you sure that you don't mean the United States of Bum-Fuckistan or something? And you’re sticking with that story? Is anybody buying it?

This is the same failed casino boss Donald Trump who has been lurking around the leaders and gutters of the haunted mansion that is American culture for the last forty years? Do you mean that asshole? What happened, they had an election and nobody signed up?

Do you mean the same guy that Jimmy Breslin called “Between You and I” Trump? Breslin knew how to treat the object of a preposition, not like some people.

If this turns out to be true, I am going to be very disappointed in the American electorate. Wouldn’t be the first time, I guess. But it might be the worst.

Now I know how Rip Van Winkle felt. 

Wednesday, August 23, 2017

The Hollies - Carrie Anne

This week in Set-Up-And-Play, The Hollies!

I have always admired a band that could set up and nail their hits live without breaking a sweat. I'm pretty sure that this performance is live in all of its particulars. These guys were an excellent band. They're nailing the vocals here too, not long after Graham Nash left the group. They seem to have recovered nicely.

The Hollies are a cautionary tale about the difficulties of making a living in the music business. They were great, and they were popular, but they never made the big bucks. They worked hard, too. They had something like fourteen consecutive top-ten hits in England, quite a few of which sold very well in America. Their LPs, though, languished in the second hundred on the Billboard charts, and they were never a stadium band. If it couldn't be done with talent like this, and great material, man, that is one tough gig.

Tuesday, August 22, 2017

The Flares- Foot Stomping (with and w/o vocal track)

With and w/o vocal track . . . don't see that every day. It's a little easier to hear the band parts without the vocals, but only a little bit easier. The Hammond B3 uses up a lot of the oxygen in the room. Nice to see how a very nice little pop tune came together, though.

The video starts out with a full delivery of the with-vocals version as released. Part II starts at about 2:15, and the change-over is identified in the visual portion.

Spin Easy Time!: glitter S.P.C

The music video in this old post still plays, so go ahead and play it again if you want to have some fun.

The Glitter S.P.C. is a car club in Japan, and they got their copy of this record the same way that I did, no doubt. It came in their subscription copy of Gearhead magazine! I don't think that it was ever released in any form at all, so I'm pretty sure that obtaining a copy of the magazine was the only way to get it.

Spin Easy Time!: glitter S.P.C: Great video, great cars, and for a soundtrack one of the greatest 45's of all time.  "He's Waiting," by the Meices!  Wh...

Monday, August 21, 2017

Mystery Bugs in Houston, TX

It's not just Trump. I think that the world is getting weirder in general.

Sunday, August 20, 2017

"I Love You" by the Volumes

Oh, I can't leave you hanging. Ladies and gentlemen! The Volumes!

Foot Stomping by the Flares 1961

In hindsight, I really like these cuts that existed between the true Doo-Wop era and the true rock band era. The very early 1960s. The singing is very Doo-Wop, but the production is much glossier, enabling a much more fully developed band sound. They had a hell of a time recording drums at all in the mid- to the late 1950s. In some of those older records they literally put a microphone inside of a cardboard box and played the drum part on that. Contrast that with the resolution on the drums here. Very nice.

The Gold Standard of this period of Baroque Doo-Wop meets Nascent 60s Rock is "I Love You," by the Volumes. This right here is a very nice cut, though. At least I think so.

Thursday, August 17, 2017

An Architectural Jem In Bangkok

This is my favorite building on my campus, which is Ramkhamhaeng University in the Bangkapi neighborhood of Bangkok. 

Bangkok architecture is an interesting mix of the very imaginative and beautiful, a huge middle ground of the utilitarian and ordinary, down through the merely disagreeable to the truly awful. It's such a big place that there's plenty of room for top notch buildings, though. I like this one a lot. 

Cool Vehicle Alert: The Honda Cub

Thailand is full of these small step-through frame basic transportation motorcycles, full of them like the ocean is full of salt water. Honda dominates the market, with Yamaha as a distant second and Suzuki somewhere in the way-back. Most of the Hondas by far are Honda Waves. There are multiple Wave models, with engines from 100 to 125 cc.

For the younger crowd, Honda sells the Nova. This is a 125 cc bike with a six speed gear box and a fully manual clutch. (The other bikes mentioned in this post have semi-automatic clutches, just kick the shifter.) Novas are nice bikes, pretty fast for their size.

Honda still sells the Dream, too, but it's not very popular anymore. The Dream is a 125 cc bike with an old fashioned set-up. All of the Waves and Novas have disk brakes up front; the Dream still has a drum brake. People think of the Dream as an old lady bike.

Honda also sells the Cub. You see these very rarely, and I really couldn't say what the market niche was. These pictures are of two Cubs, looking brand new, right next to one another. Seeing one is unusual; seeing two parked together was kind of a shock. The Cub has the front drum brake of the dream, and very little in general to differentiate it from a Dream. I should look more to check the engine size, there are no badges and that's usually the only way you can determine the engine size. We'll see.

El Pito (I'll Never Go Back To Georgia) - JOE CUBA SEXTET

Puerto Rico has been kind of a step-child of the United States since we stole it from Spain almost 120 years ago. I don't know how I'd feel about the whole thing if I were Puerto Rican. I can't help feeling, though, that it might be a relationship that has worked out well for everybody.

Not actually being a state, Puerto Rico has been able to retain its unique cultural identity and its language, and, perhaps most importantly, its music. Having a close, official status as part of the United States has given an American spin to the mind-set of Puerto Ricans. Who knows? It might be the best of both worlds.

The music made in New York by Puerto Rican musicians is a wonderful contribution to American culture, that's one thing for sure. These Newyorican bands wrote the book on fun; everything they play is fun. It sounds like fun; it sounds like they all had fun making the music; listening to the music is fun. It all makes you smile, and want to dance.

For non-Puerto Ricans like me, having Puerto Rican friends, or Dominican or Cuban friends, and getting invited to their parties, was a great bit of luck back in my day. Those could be some "no tomorrow" parties, and you never knew what would happen. Things could get wild.

I don't know how Puerto Ricans feel about the relationship at this point, but I, for one, am just damn glad to have them in the mix as genuine citizens of the United States. Thanks for everything!

Monday, August 14, 2017

The God That Is In Us

Or, Everything that I Needed to Know in Life, I Learned As a Baby. 

Babies are born, and they seem to just lie there and do nothing. It’s an illusion. They are actually very busy. From the first day, they are listening carefully to all of the new sounds that are reaching their ears, newly freed from their watery habitat. They are beginning to explore movement in a less restricted environment, moving their hands and arms and legs. Soon they open their eyes, and they begin a close study of the thing that interests them the most:


Babies are born with large brains that work perfectly well. They cannot speak, nor can they understand spoken language, and for that they are intellectually short-changed. In reality, they are neither stupid nor ignorant. They are innocent. Their brains are working fine, but there is very little information up there to work with. They immediately set about to remedy this situation by closely examining the world, and the people, around them.

Many aspects of this new reality are distressing. Babies have all had a longish period of awareness in utero before being born into the outside world. They found their time in the womb, I daresay, rather pleasant. It was warm, and the temperature was constant. Sounds were muted and indistinct. Nutrition was delivered on an almost constant basis, and waste products were effortlessly removed. Movement was restricted, but if you ask any mother you will be assured that babies get plenty of exercise and move around quite a bit. Just as they are becoming accustomed to this peaceful existence, they are painfully expelled from it. Those muscular contractions that are making mom scream in pain are no party for the baby either, I’m sure. They are expelled, and/or dragged, or sometimes suddenly cut out. Then there’s the bright light, and the sounds and the smells, and the breathing, and the crying, and the absence of the mother. Her heartbeat! The mother’s heartbeat had been the sound of being alive, and now it’s gone! That can’t be a good feeling.

Chief among these discomforts is doubtless the feeling of hunger. Blessed is the baby who is immediately delivered into the warmth of its mother’s embrace and breast fed. In any case, the baby will presently discover the frequent feeling of hunger, and hunger will teach the baby the most terrible truth of its life:

The baby is helpless.

The baby feels hunger, and soon realizes that it is only with outside help that this awful feeling can be mitigated. The baby itself is powerless to remedy the situation. It can only cry, and hope that somebody is listening. Hopefully it will be somebody who will understand the crying and compassionately render appropriate assistance. This understanding of helplessness brings new urgency to the baby’s study of faces.

Babies look at faces and immediately see differences between them. These are not value judgments, they are not based on beauty or its absence. Babies can instinctively see that some faces are positively disposed to the baby while others are not. Those cheerful, loving faces are much more likely to respond to the baby’s hungry cries. Babies begin almost immediately to encourage this profitable relationship with sympathetic adult faces by smiling, gurgling and cooing. They are saying, love me! Care for me! Clean me! Feed me!

They do this out of desperation, but also with love and appreciation. Tender, loving caregivers will be repaid with the child’s love as it grows through the stages of life. As helplessness is gradually replaced by independence, the child’s gratitude will remain if the relationship, like the child, is nurtured. This is the greatest gift of parenthood for those lucky enough to have been successful at the job.

Well, that’s a nice story, but how do I come to write it up today, on this day in particular? It happens that during a taxi ride yesterday it occurred to me that the baby’s experience in infancy was the beginning of the child’s understanding of right and wrong. It was no less than the foundation of the child’s value system for life. Looking for those happy, helpful faces taught the baby what is good in life. Worrying about those stern, unhelpful faces taught the baby what is bad. Helping people is good. Letting them suffer is bad. In the baby’s simple, straightforward life-and-death situation, compassion and the willingness to help the weak were identified as the best attributes of all of mankind.

This is not all speculation on my part. I have read about studies that involved older babies, immediately pre-verbal babies, say six or seven months old. They are propped up in a car seat in front of a kind of Punch and Judy show. As puppets are introduced, the baby’s facial expressions are videoed and studied. The babies’ emotions regarding the puppets and the dramatic action can be readily seen. The puppets are not designed with visual clues as to their personalities; whether they are kind or unkind can only be seen through their movement and their actions. They do, however, have features that can be recognized. Perhaps one puppet is short and faced with food on a high shelf. It tries to reach the food but cannot, and it appears to be in distress. The babies read this information very well. Now another, taller puppet enters the stage, and helps the first puppet reach the food, which the “hungry” puppet enjoys. The baby is delighted.

In another vignette, a puppet enters the stage eating something. Another puppet comes onstage and steals the food, causing the first puppet to act upset. The baby observing this action is horrified.

Later on, one of the “good” puppets comes on stage alone, and the baby shows delight at the very sight of helpful puppet. By the same token, the mere appearance of the “unkind” or “bad” puppet causes the baby distress. Voila! Their understanding of good and bad is fully formed.

I am sure that this experience leaves a permanent presence in the baby. We grow up with a “conscience,” a voice inside of us that counsels us on the correctness of a particular course of action. As in, “his conscience was bothering him,” i.e., because he had done something that he knew was wrong. Or asking someone who is considering a course of action, “what does your conscience say?” My hypothesis today is that this voice inside of us is God.

Yup, I just said it. And I mean it just that simply. The voice that most of us have inside of us that guides us towards empathy, compassion and cooperation is God. We all have our own God in our minds, and the general chorus of these multiple Gods acting in concert is God overseeing the progress of life on earth. Observed in practice, it is the chief force for good in the universe and the one thing that allows human life to prosper. Without it, we would be much less than dogs, less even than the apes. We would be struggling in selfish chaos like alligators or something.

Without it, we would be sociopaths, considering only our own needs and wants. Without it, civilization would collapse into anarchy in a matter of a few years. We struggle these days with the curse of those among us who lack it entirely or in whom it exists only weakly. I’m talking about these Ayn Rand following lunatics that have become unaccountably successful in politics and the justice system of late. Even in Hollywood, if you count the Scientologists. It’s like a virus that has entered our public discourse. But I guess that’s another subject.

So, parents, do all that you can to strengthen the developing consciences of your children. Help them to become right-thinking adults. And people, listen to your consciences as you go through life. To fail in these attempts has consequences. The God in our heads is powerful. It can make you ashamed of yourself, or it can make you proud of your actions. Which do you prefer? As you lay dying you will judge your own life. This is the only judgment that you should fear. Would you prefer to lay there feeling like you did a pretty good job of it, recalling family and friends whom you loved and helped, and times when you were thanklessly kind to strangers? Or would it please you more to remember only your money and possessions, while realizing that you missed every good opportunity to be kind to anyone, as your family goes about their business wondering what to do with your money? “What the fuck was I thinking!” is not a thought that anyone should want to be the last on their minds.

Make your beds, my friends. Someday you will find yourselves lying in them.  

Sunday, August 13, 2017

DNC "Spokesman" Proposes Medicare For All - Stuns Crowd

You can watch this with reference to the below post about our do-nothing Democrats. The "DNC Spokesman" here is an actor with the satirical group called the Yes Men. (The female moderator is an actress as well.)

This droll piece is very funny because it is a simple statement of what all Americans want and what the Democrats obviously should do. It is what the Democrats would do if they were not a fully bought-and-paid-for component of the new something, whatever you want to call it, corporatism, neolibralism, pick one. It's like God . . . whatever you call it, it is what it is.

The Republicans, love them or hate them, at least have the courage of their convictions. They want the money, and they want to be the permanent face of the Clampdown. That's what they stand for. The Democrats want the money too, and they think that the Clampdown is fine, but they won't admit to being actually "for" anything.

Oh, shit. We are so screwed.

Saturday, August 12, 2017

Single Payer; Universal Health Care; Dare I Say It? Socialized Medicine!

What effect would single payer health insurance have on the taxes that we pay? 

Single payer is shorthand for a health care system in which all citizens, often all people within the jurisdiction of the country, are completely covered for all medical care at no immediate cost to them. All medical expenses are paid by the government, in the case of America that would be the Federal government. They are paid out of tax revenue. What would be the effect on household finances in real time if such a program were instituted?

I am not one for long hours of detailed research, so I’ll be basing all of the figures and suppositions in this post on a cursory look around at some Google research. I chose the example of France as a benchmark for projections of costs and savings that would show up in America. Bear in mind that I am a lawyer by training, and lawyers tend to prefer very round numbers in every situation. All numbers in this post are of the very roundest variety, and are proposed as a very rough idea of what might happen if America chose to put such a program in place.

The Numbers

I’m looking chiefly for the amount that our personal income taxes would rise to cover the expense of single payer insurance. My source for the American figures was Google in general. My source for France was a WHO website.

The total revenue of our income taxes in 2016 was 1.8 trillion dollars. ($1,800,000,000,000.)

The total annual cost of health care in America is 3.2 trillion dollars. ($3,200,000,000,000.) (I believe that figure is also for 2016.) This figure represents seventeen point eight percent (17.8%) of the GDP of the United States. This makes the amount spent annually on each American about ten thousand dollars ($10,000.). We must remember that this figure includes the many levels of profit in our current system, so the amount actually going towards the provision of medical care is much, much less.

I looked to France to discover what happens when you take the profits out of the picture. Annual medical expenditures for individual Frenchmen are four thousand, five hundred dollars ($4,500.) That’s less than half of the costs now being incurred in America. The total expenditure in France takes up eleven percent of their GDP (11%). It is safe to say that the French have achieved this savings by taking profit out of the equation. The quality of French health care, and the French standard of care itself, are fully the equal of similar services offered in America.

This seems to suggest that the total expenditure for health care in America would be reduced by something like fifty percent (50%) if profit were removed from the mathematics. That would bring our total expenditure down to about one point five trillion dollars ($1,500,000,000,000.).  

That figure is very close to the total current revenue of the income tax, suggesting that personal income taxes would need to almost double. It is, however, likely that whatever scheme was adopted would also draw on corporate taxes and excise taxes. Bear in mind that corporations are currently paying the premiums for a large part of the health insurance policies already issued as employee benefits. Federal corporate tax revenue in 2016 was one point two trillion dollars ($1,200,000,000,000.).

In my opinion, both individual income taxes and corporate taxes are currently artificially low. Both were higher in the not so distant past, rather higher in fact. Those higher levels of taxation never seemed to bother either rich Americans or American corporations. Both groups thrived. Both groups can afford to pay more.

So, The Increase

I’m afraid that my skills as a statistician are not sufficiently sharp to come up with a projection of the rise in personal income taxes that would be needed to pay for a single payer system. But there are dim outlines visible.

Right now, about thirty five percent (35%) of American incur no Federal income tax liability. (I used the Motley Fool website for this section.) Of the ninety-seven million people who do pay Federal income taxes, the average adjusted gross income is ninety-five thousand dollars ($95,000.). The tax paid by those individuals is fourteen thousand dollars ($14,000.), which is rate of about fourteen percent (14%). These are the lowest personal income taxes in the known world.

If the 1.5 trillion dollars payable to health care providers is added to the 1.8 trillion dollars currently collected, the projection for necessary Federal tax revenues is 3.3 trillion dollars. Let’s just say that the tax burden about doubles. Applying that increase to the average amount paid, the average tax paid by those ninety-six thousand people would jump to $28,000, with the rate climbing to 28%.

That is enough to make people scream, but let’s take a minute before hysteria overtakes us. For one thing, that simple math does not take into account the contribution of corporate tax revenues. And for another thing, the additional money paid out is immediately offset by a reduction in health care costs to zero. Americans at all income levels would save a substantial part of their discretionary income, and the country at large would experience a drop in health care costs to a much more manageable level. Most people’s incomes would rise. There would be additional benefits. Preventative care would receive much more attention. So would chronic conditions. The problem of the uninsured would disappear. The standard of care would rise, because the application of necessary care modalities, like MRIs, would no longer depend on the level of someone’s insurance coverage. The general health would improve. And these are only the financial and medical benefits.

Think also of the emotional benefits! Families would no longer be financially destroyed forever by the birth of a baby suffering from, let’s say, cystic fibrosis. No one would ever need to worry again about the concept of a “lifetime cap” on benefits. Families and individuals would no longer need to “impoverish themselves” in order to qualify for the Federal Medicaid program. There would be a collective sigh of relief as people became medically secure. The general financial security would be enhanced.

Most Americans are paying more right now for health insurance than they are for Federal income taxes. So even if the taxes double, they’ll save money, while gaining some welcome peace of mind. For anyone who pays more for Federal income tax than they do for health insurance, their incomes are so high that we shouldn’t devote too much time and energy to worrying about them, now should we?

Who Gets Hurt?

The health insurance companies? The ones who cheerfully cash your checks for years and then deny payment when you make a claim? The ones who tell you that your son or daughter will just have to die because that life-saving medicine is too expensive, and your soon-to-be-dead child will just have to make due with some cheap-ass fifth string medication? Those companies? Who will cry for them? Not me.

The hospitals? They were all non-profits until recently, and they can make do again in that honorable condition.

The doctors? They’ll be better off! They’ll be able to practice medicine again. Money will no longer be their main concern. And they will still be in the top five or ten percent of wage earners, so don’t worry about them losing much money on the deal.

Your congressman? Yes, he will no longer have the medical industrial complex tit to suck on with all of his might. Perhaps he’ll open a hardware store back in Old Rag, West Virginia, and leave us all alone while someone more qualified takes his job in the House of Representatives.

The Effect, As Experienced By Others

How about France? How’s that universal health care working out for them? My oldest son went to France for a semester back around 1990. He’s a healthy lad, but he did have one bout of misadventure while skateboarding in Lyon. His friends took him to the hospital with a painful hyperextended knee.

He got the greeting that any Frenchman would get. They asked him his name, and wrote it down. He was admitted, and a work up was done. X-rays were taken, and he was seen by an orthopedist. He was given a thorough exam, the x-rays were examined, and he was diagnosed with “nothing to worry about.” They gave him some instructions, some anti-inflammatory medication, and they gave him his x-rays to take with him, “in case you get back home and you need further medical assistance.” His bill for this was about eight dollars. I think they charged him for the carry out x-rays.

In America this would have been a $1,500 emergency room visit.

I recall a news story in the 1990s about an American woman who went to France for vacation. While she was there, she suffered the onset of some kind of condition, maybe heart related. She presented in the French hospital and received treatment. The condition was somehow chronic, and it required additional treatment, but she had no health insurance. So if she returned to America, she was in financial distress immediately. No insurance! A pre-existing condition! The story was that she remained in France, living essentially either in railway stations or on the street, so that she kept her access to life-saving health care. No one should have to live like that, or make choices like that.  

Americans love to complain about taxes. But what if the taxes that you paid actually did you some good? Many Americans do think that it’s nice to consider the eleven multi-billion dollar aircraft carriers that lurk all over the world on our behalf, but that stuff is expensive. Wouldn’t it be a better idea to spend some of that tax money on health security? Some of it, that’s all I ask. Wouldn’t we be grateful for the peace of mind that comes with not having to worry about “how much is this going to cost me?” every time your child gets hurt at the park?

Other developed countries? I live in Thailand, and I occasionally run into visitors from other parts of the world. Rarely do I encounter American tourists. It’s not the expense, many Americans could afford a vacation in Thailand, it is the time involved. Europeans get vacations that run to weeks at a time, often a month at a time. Most American workers, labor or management, get two weeks a year and your boss won’t let you take them all at once. No, it’s one week at a time for Americans. That’s not enough days in a row to vacation in Thailand, where the flights are more than twenty-four hours door to door, and then there’s the jet lag. But I have spoken to several Norwegians over the years. Their experience is fascinating.

I ran into a guy down in Krabi a few years ago, a bachelor from Norway. He was not a big shot, not a highly educated person. He vacationed every year in Thailand for four weeks during the winter months. We had a nice chat. I asked him about his taxes, and he gladly admitted that he paid over fifty percent of his salary in taxes. He was proud of the system, and grateful for all of its advantages. He didn’t have to worry about anything. All medical expenses were paid; he got more than six weeks of vacation every year, plus lots of holidays; there’s nothing called a “sick day” in Norway, if you are sick, you don’t go to work; his retirement was assured, including a place to live and all expenses; he felt like he had it made. And by the way, that fifty percent tax rate was deducted from a fair wage. He was a very ordinary guy. He had two jobs: in the summer months he worked in the forests for the government, and in the winter months he worked in town for a library or something. For this, his annual salary was 90,000 Euros. So after taxes he had plenty of money to live well and fool around in Thailand for a month every year.

What about our neighbor to the north? Canada has the kind of health care that we should have, if there were a just God. Have you ever heard of a Canadian complaining about their single payer health care? Dare I say it, their “socialized medicine?” Why no, you have not. There’s a good reason for that.

We should have it, too. And some day, I believe that we will. It’s going to take a while, though. That’s because no one in our government gives a good God-Damn about us. We are expected to work our asses off, and pay taxes, and fight their wars, and never complain or demonstrate in the streets lest the demerits go on our permanent records, and expect no consideration and settle for the few crumbs that fall off of the rich man’s table. Thank you sir! Oh yes sir, I am content, sir! Don’t worry about me sir! Yes, little Johnny who had a heart problem lives with God now, sir, and he’s better off! We’ll be fine, sir! It’s all sickening.

I only hope that the necessary adjustments can be made without the application of the traditional methodologies and tools of the past. Those would be the old Captain Midnight routine, piano wire, incendiaries, hooks, the Hearts of Oak, guillotines, explosives, and rope. The old "not a stone left standing on a smoldering stone" routine. It’s rather embarrassing when that happens, because it’s such a failure of dialog and diplomacy. History is full of it, though. Just remember.

Disclaimer: I am against violence in every form! Please, dear Federal overseer, don’t put me on a list! My counsel is always that peace should be the way in all things! I live a quiet life, and I like it that way. 

Dave Mason - Only You Know & I Know

Okay, Dave Mason was underrated, that's true, and this is a great song, sure, with a couple of nice covers out there, but today I'm mostly concerned with tone.

Dave played the Gibson Thunderbird, which is itself an underrated guitar. it was never popular for some reason, maybe the price was a bit high. The Thunderbird used mini-Humbucking pickups, it might have been the only guitar to do so. They had a very particular sound, which is evident in this song. I like it a lot. The electric guitar chording in this song sounds just great. The melody parts do too. All very Thunderbird.

Don't you think?

Thursday, August 10, 2017

Where Are The Democrats?

The news every day is a Britannica of stupid coming out of the White House and congress. I say the White House, you know, but I mean wherever the Donald happens to be, Mar a Lago, a MacDonalds, some other golf course, France, a campaign rally out in Kick Stump, wherever his 3G is getting the hook-up. Don’t allow loose talk about how the Republicans “can’t seem to get anything done” to fool you. They’re getting plenty done. And it’s all either stupid, mean-spirited, contrary to American values, treasonous, venal, vaguely unconstitutional, or borderline criminal. Regulatory changes; judicial appointments; more Gerrymandering; policy changes at Federal agencies and cabinet departments; that whole anti “voter fraud” program; the purging of voter lists in general; the demonization of all non-white Americans; and the jettisoning of any government decision or rule that might help non-white Americans or promote science or justice; this program has been going great guns since the inauguration, with considerable success. What has been the response of people who preferred the direction that America had been going in for the previous hundred years? Good question.

Thank God we have the Democrats to protect our democracy with their ingenious, comprehensive, and vigorously pursued program to limit the damage to our great American experiment in self-government!

(Switches to Stephen Colbert’s smug expression and tone.) “Only kidding!”

No, the Democrats do not seem to be too worried about, nor even particularly aware of, what’s going on. They are not challenging anything; amazingly, they are not even complaining about the Republicans ramming through rule changes and forcing through dozens of Federal judge appointments, the same appointments that they denied to President Obama for eight years. The Democrats have yet to advance one attractive candidate for any office, either now, for special elections, or for 2018, for what will be a spectacularly important off-year congressional election, or for the next presidential election in 2020. What are they waiting for? There have been more than a half-dozen special elections for congressional seats since Trump was sworn in. The Democrats have managed to lose almost all of them. If the Democrats are trying to formulate a plan, it is still a deep, dark secret, and if they are taking any baby-steps to counter the immediate threats to our way of life, those steps are invisible and ineffectual.

Standard Disclaimer for rants like this: Yes, I am aware of Bernie Sanders and Elizabeth Warren. Yes, I like both of them very much. Yes, I find them to be highly intelligent, articulate, good-hearted and hard-working people, and I am glad that they are in the Senate. Two individuals is not even a good start, however. It’s John the fucking Baptist announcing a movement that may or may not gather followers. So far, it looks like “not.”

The Democrats at large can't seem to agree on anything, with the possible exception being their general dislike of Debbie Wasserman Schultz. Okay, that was agenda item number one. She now wanders outside the city walls. Can we move on to item two?

They do have a new slogan, the Democrats do. It’s so lame I won’t even repeat it here. It’s an obvious copy from the slogan of the mediocre pizza chain, Pappa John’s. They might as well have adopted the slogan, “mom, apple pie, and Christmas.”

I guess that we can forget about help from the Constitution as well. The Constitution has several mechanisms for blocking a duly elected but obviously unqualified president from taking office, or removing one who either abuses his power or proves himself to be an idiot. They are there for anyone to read, and we are all justifiably proud of their words standing strong in that great document. We are now discovering to our chagrin that in its current interpretation by the American legal system the Constitution is a SUICIDE PACT. In spite of his having lost the actual vote count by a rather dramatic margin, and despite being possessed of a lazy and weak mind, with no relevant experience for the job, Donald Trump was the clear winner in the all-important Electoral College, so we’re stuck with him for at least the next four years. Plus four years after that if the electorate and the voting process itself can be rigged for the second time in a row, and we'll be stuck with him forever if the Republicans can achieve their “final solution” to the problem of national elections. Two hundred years from now, a hologram of Donald Trump could still be the president of the United States. Would the hologram say the same stupid things over and over again, or would they put intelligent words, or maybe homilies, in its mouth? Nothing would surprise me anymore, although they’ll probably go with a hologram of Reagan when the time comes. He’s more likeable. How about John Wayne? The Duke! We’ve broken the stupid barrier, people. The stars are the limit!

Alas, Babylon! Are we to be covered with the same dust that now blows over the bones of that once-great city?

Or, in words that will probably be more attractive to most Americans, will we still have big flat-screen TVs? Will there still be wi-fi? Netflix? 4G? Will there still be Happy Hour dinner specials at Applebee’s? Will they keep the taxes low on beer? Can I keep my car? Will there still be recreational weed? Will there be a season four of Better Call Saul? Will Dirty Johnny still sell bootleg Oxy?

If we can still have most of these things, it is likely that most people won’t care what we lose in the way of freedom, equality, and democracy. Most strongly in the “not caring” column will be the straight, white Americans from places you've never heard of who voted for Trump in the first place. Let’s face it, it has always been better to be straight and white in America, and it’s getting better every day, even as we speak. If they can put the straight, white Americans back in charge, it’ll be over for sure. This will not end well.

As always, the blogger wishes us all a hearty Good Luck! Bon chance, mon Ami! Viel Gluck, Landsman! And remember, in good times you have a certain measure of rights, but in bad times, all you have is the right to get your head cracked open by a night stick. So be careful, you. 

Wednesday, August 9, 2017

All Your Love --- John Mayall's Bluesbreakers

Just as a point of reference. Good cover version. Reverential, even.

Otis Rush - All Your Love (I Miss Loving)

I loved that first Bluesbreakers LP with John Mayall and Eric Clapton. I'd never heard Otis Rush at the time, where would I have heard that? I knew Clapton from the Yardbirds, and I bought the Mayall LP on spec. Good choice. Otis Rush came into focus for me later on.

Back in the mid-1960s, all of the white guitar players talked about B.B. King, or maybe Muddy Waters, as influences. They were important, but it was only about five percent of the story. B.B. King deserved all of the credit and acclaim that he received, but somehow no one mentioned T. Bone Walker. Except B.B. that is, and even that was later on. Lonnie Johnson? No one ever mentioned him, not that I know of. Those were technique guys, but how about tone? Guitar Slim was a guy who really pushed the overdrive in those early Fender amps; Johnny "Guitar" Watson was always out there, too. Bo Diddley played harder and heavier than anybody in the late 1950s, but you never heard much praise for him as a guitar player. There are so many fellows that you just never heard much about at all. Earl Hooker, oh hell, if I make a list I'll just leave important musicians out.

To their credit, a lot of those young English musicians listened to some great records, and learned some great lessons. Eric, and John Mayall, had obviously studied the hell out of those early 1960s Otis Rush records on Cobra out of Chicago. It's nice that some fellows stood on stage and mentioned B.B. King during their shows, in the midst of playing the guitar with influences from B.B. and others. I don't find anything objectionable about being influenced in one's playing, it's music after all. All music is theft. It would have been nicer though, and more polite, to have mentioned some of the guys that were being quoted extensively but never recognized, like Otis Rush on the Bluesbreakers LP.

I have a hunch that Otis came out of it okay. He seems to have had a very full career playing on stage, so he probably made a living while he was at it. He's no kid anymore, and I think he's retired by now. He was born in 1935, making him 82 years old as of this writing. The documents are out there for history to see and hear. I have a hunch that people will be listening to Otis for a long, long time. The man could play.

Our Medical Nightmare, Part II

This post was written after reading “Putting Profits Ahead of Patients,” by Jerome Groopman and Pamela Hartzband, which appeared in the New York Review of Books on or about July 13, 2017. The beginning anecdote and some of the information in the post were derived from the article. All quotes are in quotes, so to speak. The article referenced the book, “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back,” by Elisabeth Rosenthal (Penguin Books).

The Problem With Health Care

A lawyer in New York City gets chest pains during some kind of strenuous game. He is fully insured. He is taken to a hospital where he gets the standard medical responses to chest pains, an echo-cardiogram and a cardiac stress test. Tests show that he is not having a heart attack, and he is released from the hospital. The pains are judged to have been stress related. The bill is $8,000; his insurance agrees to pay $6,000 and the hospital begins to dun him for the $2,000 co-pay.

Luckily, he has a relative who is a doctor. (The relative is one of the authors of the article on which this blog-post relies.) The doctor/relative agrees that that seems high, and suggests that the lawyer call other medical providers similarly situated and check their prices for those procedures in that situation. The prices fall into the range between $1,500 and $6,000. The lawyer refuses to pay the extra money to the hospital, which immediately cancels the co-pay, settling for the $6,000 paid by the insurance company.

Reality Check: Something similar, but much less dramatic, happened to me recently. A very good and highly regarded “international” hospital in my Bangkok neighborhood charged me $240 for the very same stress test and echo, albeit not in the emergency room situation. No waiting, and no appointment. I walked in on a Sunday and within twenty minutes the doctor was getting started on the tests. This was all done with state-of-the-art equipment, by a fully qualified cardiologist and a nurse. The result was the same in my case: my heart is fine. I have the heart of a healthy three-year-old racehorse, but evidently my stress is getting to me. $240, put that in your pipe and smoke it. That cost is not a typo, the full charge for my visit, including both tests, was two hundred and forty dollars ($240; 7,900 Baht).

We all know that something has gone terribly wrong, we Americans.

Some History

Medicine was a primitive affair until the early Twentieth Century. There were no antibiotics, and anesthetics were basic and crude. What services could be provided were fairly cheap, all things considered. As medical knowledge increased over time, so did costs.

Hospitals were not in the business of making profits back then. They looked for ways to cover expenses. In the 1920s, Baylor University Medical Center in Dallas came up with a way to regularize their cash flow. It was a “subscription” service that people could join for $6 per year. If they ended up in the hospital, the sixth day of the hospital stay was free, all inclusive. (The regular price of a day in that hospital at the time was $5, which was almost a week's pay for most people at the time.)

This Baylor plan became Blue Cross, which was also a non-profit corporation.
Blue Cross begat Blue Shield, another non-profit outfit. They were called “the Blues.” By the 1960s, about fifty million Americans were covered by the Blues. They merged in 1982. Blue Cross/Blue Shield accepted all applicants, and there was one rate for all covered individuals. They retained their non-profit status until 1994, when industry pressure forced them to seek profits to remain competitive.

Employer Based Health Insurance came about almost by accident. A law was passed in 1943 making all of the money that companies spent to pay for employees’ health benefits tax free. Wartime wage controls were in place at the time, and companies jumped on health benefits as a way to attract workers. The government tax policy, and the companies’ habit of providing health insurance, stayed in place for some time.

From the 1960s to the 1980s, more and more for-profit health insurance companies came on the scene. Prices started to shoot up, which drove more people to seek insurance. Medicare and Medicaid came on the scene. All of these multiple payers had the effect of driving prices up, and up, and up. By the 1990s, many hospitals were still nominally non-profit, but they were chasing “excess revenues” and becoming rich without paying taxes. The for-profit insurance companies loved nothing better than NOT paying claims, so refusing payment became more common. The whole system of health care was becoming money crazy, and we were all becoming health-insecure. (“America’s Bitter Pill,” by Steve Brill [2015])

Reach For The Stars!

Today we are stuck with a system where medical providers size us up and decide how much to overcharge us as a matter of course. Like the stress-test and echo that opened this post, providers know that they must reach for the stars if they want to end up with the moon.

Rosenthal tells a story about a plastic surgeon who did a small job on a girls face. Not like cosmetic surgery or anything, not a nose-job, nothing corrective, just three stitches on a cut. His initial bill was $50,000 (fifty thousand dollars). Why not? She had good insurance. Maybe they’ll pay it! A concerned medical association got the bill reduced to $5,000, which still seems astronomical for a few minutes work.

Medicare, Etc.

The problems with Medicare and Medicaid are under-reported, because those programs are well loved and generally work pretty well. Regarding Medicaid, the worst effect is on the standard of care that all Americans are due at the hospital. Per current law, anyone who presents at a hospital in distress must receive care. This is what Republican congressmen call, “nobody dies!” “You just go to the hospital!” And it’s true, if you are in acute distress, you will be treated. The hospital will then generate a bill, and they will explore ways of collecting on this bill. If the patient is homeless and bereft of resources, the debt is uncollectible. It is then presented to Medicaid, which will negotiate the bill and pay the agreed upon cost. If the patient is merely poor, the bill in collections becomes problematic pretty fast. Property can be seized, or wages garnished. An already marginally above water patient can be therefore pushed under the waves.

How about the standard of care? What level of care does the hospital owe a virtual beggar who just wanders in? If you show up at a hospital in a diabetic coma they must provide acute care sufficient to stabilize you, that’s it. Then they put you out in the street, with no medication and no follow up. That’s a problem. The law says that they owe you the same standard of care that everyone receives in the meantime, and that presents its own problem. The result has been that the general standard of care has been lowered, to avoid running up big bills treating the indigent.

So whereas in France, let’s say, if you show up with a non-specific stomach ailment that has caused you to suffer a ridged abdomen, and x-rays do not show any condition that would cause that very serious, and very painful condition, you will be given an MRI. That’ll get to the bottom of things pretty quickly. Those are expensive, so as we speak they are part of the standard of care in France but not, I think, in America. They certainly didn’t do one on me when I presented with a ridged abdomen as a Medicaid patient. Luckily for me, the list of things that can cause a ridged abdomen consists of only fatal events, so they decided to do an “abdominal exploratory,” discovering after a full and comprehensive tour of my abdominal cavity that my appendix was way over in a strange corner and tucked behind a bone, and it had burst. An MRI would have displayed the appendix and its condition. I lived, thank God, but I’d have a much smaller scar if I’d gotten the MRI, and my recovery would have been much faster and easier as well.

Medicare helps, but it’s no great shakes. It’s pretty expensive; there’s nothing free about it. For Medicare A and B (doctors and hospitals), I pay about $1,200 per year, which is one month of my Social Security money. I’m beginning to wonder why I pay this fee at all, because I live in Thailand and there’s no real likelihood that I’ll ever move back to the States. Medicare does not make any payments at all for services rendered outside of the United States of America. There are many people like me who lived and worked all of their lives in America, paying taxes, raising children, contributing to communities, serving in the armed forces, and generally being good citizens, but are now denied the benefit of our bargain with our government, denied the benefit of Medicare that we are owed by the law. Isn’t that a little shameful? I find it so.

And what would Medicare pay anyway? It almost never pays 100% of the bill, evidently. Do you need a knee replacement? First you need to search for a doctor and hospital that will accept Medicare patients under any circumstances. Many just say, “nope, sorry.” Also, finding a doctor who will accept the Medicare money as full payment seems to be pretty rare, so you’re faced with negotiating a co-payment, which can be very expensive. In the case of a knee replacement, you will probably pay over $10,000 as a co-pay for treatment at a mediocre facility by a mediocre doctor, receiving a cheap implant that will only last ten years instead of one of the really good ones that last twenty years or more.

For me, between the cost of room and board and travel to and from America, and the co-pay, I’d save money just getting the implant in Thailand and paying out of pocket. And shut up with the “Third World” cracks. My medical experience would be as good as anything that you’re likely to receive in America, unless you’re a senator or something.

Of course, Americans with real insurance get the state-of-the-art implant and better treatment, even if they are not quite senators. They may have Medicare Supplemental Insurance. My ex-wife has that, through Kaiser. It cost her $500 per month the last time I heard. That’s on top of the $1,200 per year for A and B, and she’s probably paying for C and D as well. So she’s up to about $8,000 per year TO BE HEALTHY. Doesn’t that sound like a lot of money? Compare that to civilized countries, like France, or Canada, or Denmark, or Japan, or New Zealand, or South Korea, any of about twenty-five other countries where the government actually works for the good of their people, where her total bill for annual health care would be, of course, ZERO.

Single Payer

The solution to all of this is that we join the civilized world and provide all U.S. citizens with comprehensive single-payer health insurance, aka universal health care. America spends more per capita for health care than any other country in the world, much more, and we receive much less, much, much less. All of the extra money goes to a for-profit medical system, a for-profit hospital system, a for-profit pharmaceutical business, a for-profit health insurance business, and a network of for-profit hangers-on. It’s just bloody stupid.

There was a rush in the civilized world after World War II to move to a universal coverage system for medical care. The idea came up in our congress in Washington D.C., and the response was a deafening roar of, “oh, HELL no! That’s socialism!” That response was also stupid. I’m tired of being polite. That response was not only stupid, but also totally ignorant and quite insane.

So What Do We Do?

Americans have a blind spot when it comes to the word “socialism.” My big Oxford dictionary defines socialism as “a political and economic theory of social organization which advocates that the means of production, distribution and exchange should be owned or regulated by the community as a whole.” (Interesting that the “Oxford comma” that should appear between the words “distribution” and “and exchange” is missing from this Oxford Dictionary definition.)

That, my darlings, is a fine description of our American government, following the rules set forth in our own glorious Constitution! What part of “production, distribution and exchange” would not be part of interstate commerce? And all interstate commerce is regulated by the Federal government, which consists of representatives of the community, for the benefit of the community. Not to mention the socialistic aspects of many government programs, the Post Office, fire and police services, public roads and bridges, the armed forces, etc. Americans love socialism in its many manifestations in daily life. They even love Medicare and Medicaid. They just hate the word socialism!

This is based on an ignorant misapprehension of part two of the Oxford definition, which applies narrowly to a historical aberration:

“>(in Marxist Theory) a transitional social state between the overthrow of capitalism and the realization of communism.”

Virtually no one in the world still believes that Marxism is a thing, so we are left with the leading definition. It’s a bit late for “we don’t want socialism.” America's got socialism, in spades, and it works. To react so strongly to the mere word “socialism” is a childish, self-destructive tantrum with no arguable basis in reality. Honey, the Soviets are gone.

It’s time to wise up and move on to single payer.  Ordinary citizens in America are waking up to this idea, as though from a dream. It’s going to take a while, though, because the usual suspects stand in the way of Americans who would prefer to have nice things. All of those profit centers that would be compromised would resist single payer to the death. All of our representatives in Washington will resist, because they share in the profits generated by the health care industrial complex. All of the running dogs everywhere from the conservative think tanks to the evangelical megachurches will resist based on one foolish excuse or the other. Maybe single payer will never happen. Oh, dear reader, I dread this part of every blog post that I write, where I have said my two cents already and have run stone out of ideas without really offering any useful suggestions for a remedy. I’m sorry for that. And I’m sorry for all of us, living in, or at least being a distant part of, a country that cares so little for our well-being. And after all we’ve done for America! Cruel fate, that.