Tag Archives: RDP

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Stitch

I like to play with word cliches
Geraniums red and chrysanthemums white
As I wander busy through my day
Delphiniums blue, all are dark at night
Least said, soonest mended
Except for murder, rape and pillage
Loose lips sink ships, war ended
Sinner gossip round the village
Time will mend a broken heart
A stitch in time will save nine
You’ll never finish if you don’t start
Mend that heart and change the rhyme
Absence makes the heart grow fonder
Your love grows daily, what a wonder

For the Ragtag Daily Prompt: absence.

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Tile like

This would be amazing tile if it were tile. But it’s not. It is rock.

It is orbicular granite from Finland, gorgeous. I took the photographs in a Danish Museum in Copenhagen in March 2022.

Nature just blows me away, all the time.

And the long necked shadow? Oh, yes, that’s a fossil dinosaur skeleton.

For the Ragtag Daily Prompt: tile.

https://www.museumofevolution.com/the-permian-period

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Paw tuck

I have two desks on my main floor, and use both. Sol Duc likes the office desk and Elwha likes the other one. Sol Duc tucks herself under the lamp. I think the paw tuck position radiates peace.

I hope it radiates all over the world.

For the Ragtag Daily Prompt: radiate.

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Stand up

I am in a large room, like an expensive hotel lobby. There is a large black bowl like structure, fountain size, but without a fountain. There is a big woman bullying me. She is making me dump containers of ice into the bowl structure. It will overflow and I will be blamed. Another woman whispers to me: “You have to sing a song about abuse, so that people will know that she is making you do this.” I know songs about abuse but at that moment I can’t think of any. Then I do. I remember a song my mother sang, this verse:

“Two little babies, crying for bread. With none to give them, don’t you wish that you were dead. Don’t you wish you were a single girl again.”

I wake up. The song is about a young woman, married, whose husband is drinking up his paycheck. She and the babies are starving and he beats them. Not a pretty picture of marriage, is it?

I wake up. One way to think about dreams is that each person in the dream represents an aspect of ourselves. So WHY is my inner bully showing up? I don’t like this!

That day my friend goes from the hospital to a nursing home for rehab. I speak to three people on the team, because my friend has a cardiology appointment the next day and I want to be sure that she will be taken to the visit. She is going to a nursing home 40 minutes away.

On the appointment day, I call the rehab just after 9 am when the internet says they open. There are three choices: two halls and a main office. I leave a message on hall one. I call back and leave a message on hall two. I wait another ten minutes and call the office. No answer, I leave a third message. I wait until 9:30 and call again. This time that inner voice with gumption is fired up: “I need a call back by 11:30 or I will drive up there, I need to know that my friend has transport to cardiology for her 12:45 appointment.”

I get a call back at 10:30. The rehab person introduces herself. “Oh, we can’t transport her because she just got here yesterday.”

“You don’t understand,” I say. “This visit is to make sure her heart is ok after restarting a medicine. It is not optional.”

“We can’t transport her.”

“I am sick, I can’t transport her. What is your name? What is your position? Who is in charge of the facility? What about her heart, your facility has no concerns if her heart is poisoned?”

“Just a moment.” Papers rattle. “Oh, we DO have transport arranged. Someone else wrote it down and I didn’t see it.”

“Oh, thank you so much. I was so worried!”

I go to the appointment, masked. The driver says my friend was a last minute addition. The visit goes well. I am on the tail end of a cold, not covid, and I am very tired from trying to be sure that my friend gets good care. I think THAT is what the dream is about, the inner strong voice who is not going to let my friend be abandoned, be bullied, be ignored. She is too ill to fight for herself so I am fighting for her. And I am formidable.

For the Ragtag Daily Prompt: gumption.

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Fear and Finials

The word finial takes me straight to Portland, Oregon and Family Medicine Residency. My grandmother loaned us the down payment for a house and we were in Southeast, on Belmont Street. The neighborhood was coming up rapidly. My son was six months old when we moved there.

Across the street were two houses owned by two couples. All four worked for the Oregon Shakespeare Festival in the summers. One woman quit and started a landscaping business. She had six foot tomato plants in her back yard by the end of the summer. She had a gorgeous flower garden in front. She also put up a decorative fence with elegant plexiglass finials.

One day all the finials were smashed. We were all sure that it was Mike. Mike lived in a duplex next to us and was terrifying. Initially it was his mother living there with a potbelly pig that would use a ramp to go down in the yard. The son moved in with his wife and child. His mother and the pig left and then the wife and child did too. Before the wife and child left, Mike knocked on my door and asked about exchanging baby sitters. I explained that we had an arrangement with someone and could not do that. After he left, I told my husband, “Don’t let that man into our house ever.”

As a neighborhood, we discussed what to do if Mike came at one of us. We figured he was on crack, he was terrifying, and we should go for head or knees, because we did not think pain would slow him down. This sounds over the top, right? Nope. My little family was in Eastern Oregon for a ten week rotation. “You missed the fun,” said our neighbors. “Mike threatened to shoot himself, they called out the SWAT team. He shot himself but he missed and only creased his head. He’s in the state hospital for six months.” Except he was back in three months. I’ve also written about him chasing his upstairs neighbor into traffic stark naked, trying to hit him with a five iron. Rush hour traffic stopped dead to watch the show.

We thought the 5 iron probably took out the finials. The owner of the house next door sold it and Mike left. We were all terribly relieved. And that is what the word finial brings up.

For the Ragtag Daily Prompt: finial.

The photograph is not from Portland, Oregon in the 1990s. It is from London in March 2022.

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Double standard: AI technology can take jobs but improving healthcare can’t

The United States could go to single payer healthcare, but one objection has been “People will lose their jobs with health insurance companies.” Yet no one seems to object to AI, Artificial Intelligence taking jobs. It’s technology so it’s fine! The wave of the future! Coming whether we like it or not!

One form of single payer healthcare is medicare for all. Expand medicare so that it covers everyone. At first, it only covered retired female teachers. Women were only considered for teaching jobs if they were single. A married woman was expected to work in the home. The teaching pay was low. Men were expected to be supporting a family, so they got more. Women were often supporting parents or children if spouses died or divorced or abandoned a family or were disabled. Early census information was a finagle: any male in the household was listed as “head” even if it was an elderly disabled father or a boarder or a teen. So the true numbers of women as head of households were obscured.

Single payer would improve healthcare. There would be ONE set of rules. Physicians would know if something was covered. Right now there are over 500 health insurance companies and they each have multiple different policies. Not only that, but the policies can change monthly in what they cover. Did you know that? I would get monthly postcards from multiple companies saying that I could go on line to one of the 500 different websites and see what they had changed and were no longer covering. I found little time to learn 500 websites. We spend enormous amounts of healthcare money on communication back and forth from insurance companies to hospitals and clinics. Trying to prior authorize CT scans, MRIs, surgeries, referrals, medications (even old cheap ones!) and then attempting to get the health insurance companies to pay for the care. Remember that the insurance companies are allowed a 20% profit: so for 1 million dollars of healthcare money, $200,000 can go to profit. The people and computer work is not in that profit, so what percentage of your healthcare dollar goes to attempting to prior authorize and get paid? How much of your healthcare dollar would you like to go to healthcare?

Medicare’s overhead is either 1.4% or 6%, instead of that 20% profit and the prior auth/collection effort. There are two different estimates (from here):

1. There are two different measures of Medicare’s administrative costs. One figure comes from the Medicare Board of Trustees’ annual report, while the other comes from CMS’ National Health Expenditure Accounts. According to the latest trustees’ report, Medicare’s overhead represented 1.4 percent of its total expenditures. According to the latest NHEA, Medicare’s overheard was 6 percent of expenditures.

2. The discrepancy between the two figures is due to Medicare Parts C and D. Mr. Sullivan wrote that the difference between the trustees’ measure of overhead and the NHEA measure β€œis due almost entirely to the fact” that the NHEA figure includes administrative expenses incurred by health insurers that participate in Medicare Advantage (Part C) and Medicare’s prescription drug program (Part D). In essence, the overhead associated with the private insurers involved with Medicare raise the program’s overhead by almost 5 percent, or $24 billion in 2010.

People worry about “socialized medicine” but really, the closest system to socialized medicine is the Veterans Administration. I don’t think anyone wants to take their healthcare away, and some of it is specialized depending on where they were deployed and what they were exposed to. I saw veterans in my clinic because we were more than 30 miles by car from a VA hospital.

What about medicare fraud? I saw way more fraud with the insurance companies. Companies will maximize revenue by sending equipment at the exact interval insurance allows (like sleep apnea equipment and diabetes glucometers). It doesn’t matter to them if it’s being used or not. After my father died, there were 16 full oxygen tanks full in his house. The company was happy to pick them up and no, they did not want to reimburse the payments. A biller told me that often the health insurance companies will pay less then the contracted amount. When challenged, they say, “Oh, that was a computer error! We will fix that!” She said, “I have never once seen the error in the physician’s favor.” When I had cobra insurance, they would not pay my bills and I had to call them every single time to force them to pay. It took enormous amounts of time and again they claimed, “Oh, computer error!” I finally called their counseling line and said, “I want to be counseled for your company refusing to call me back and screwing over this cobra policy, and by the way, I have a family member dying of cancer.” That finally made them fix it.

WHY is our culture ok with technology taking jobs, while improving healthcare can’t? Get rid of the health insurance companies! Medicare for all! If we all had secure health insurance, think of the work innovation in our country!

For the Ragtag Daily Prompt: finagle.