20 August 2009

Healthcare in America: How Accessible is It?

Good day, family and friends!

I start today with the question, "Does everyone have access to healthcare in America?" The short answer is, "Statistically speaking, yes."

In 1986, the Emergency Medical Treatment and Active Labor Act (42 U.S.C., Chapter 7, Subchapter XVIII, Part E, § 1395dd, EMTALA) was passed as part of the Consolidated Omnibus Budget Reconciliation Act. This act mandates:

"In the case of a hospital that has a hospital emergency department, if any individual (or a person acting on the individual’s behalf, whether or not the individual is eligible for benefits) comes to the emergency department and a request is made on the individual’s behalf for examination or treatment for a medical condition, the hospital must provide for an appropriate medical screening examination within the capability of the hospital’s emergency department, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition exists."

It further goes on to define an "emergency medical condition" as either:

"(A) a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in—
(i) placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy,
(ii) serious impairment to bodily functions, or
(iii) serious dysfunction of any bodily organ or part; or

(B) with respect to a pregnant woman who is having contractions—
(i) that there is inadequate time to effect a safe transfer to another hospital before delivery, or
(ii) that transfer may pose a threat to the health or safety of the woman or the unborn child."

This EMTALA goes on to make it illegal for a hospital to have any sort of financially-based conversation with the individual until such time as the patient's condition has been stabilized and the conversation will not interfere with the diagnosis and treatment of the condition. Later amendments from Congress defined "individual" as "any person within 250 yards of the emergency room/department, regardless of the person's citizenship or legal status," and made it illegal for different levels of care to be provided, based on the definitions in the Act. In other words, whether you're a Mexican citizen living just across the border from a hospital in Texas, or the wealthiest American citizen in El Paso, TX with the greatest medical insurance in the world, you will both receive the same level of care if you have the same emergency medical condition and go to the same border hospital in El Paso.

Next time, we continue our look at how accessible medical care is in America. Until then, best regards...



© James P. Rice 2009

19 August 2009

Intermezzo

WARNING! Today's post is a bit longer than normal.


Good day, family and friends!

Since my last post on the 13th, I've been doing some serious soul searching. I have to admit to being more than a little surprised and shocked by the response I received from the definitions I provided, not only from my friends and family, but from others outside my Facebook 'Friends' list who read my blog. While the responses from my 'Friends' list were considered, reasonable, and in the spirit of open debate and discussion, the others were considerably more vitriolic. These less than intelligent individuals also chose to expose their true cowardly nature by sending their comments to me via e-mail rather than posting them in either of the open forums available. Both sets of comments, however, did serve to underscore the most fundamental problem with most political debates these days, and in particular the Healthcare debate: how can we have a rational, reasoned, intelligent debate about anything when we can't even agree on the most basic parameters of the debate?

I could become redundant right now and once again go into excruciating detail of how I went out of my way to make certain I did not get the definitions I used from any source that was even remotely "Conservative" on the political pendulum, but I won't. What has happened, though, is that I now understand what the main protagonist in two novels I recently read was put through as I am experiencing now it myself.

In Terry Goodkind's novels, Soul of the Fire and Faith of the Fallen, Richard Rahl believes that he can convince the citizens of a small country to join his empire by simply sharing the truth with them. The truth is that Richard's empire is dedicated to justice, to protecting individual rights, to ending corruption and cronyism, and to allowing everyone the freedom to strive to be their best free from the fear that it will arbitrarily be taken away from them. The Order (Richard's opposition), on the other hand, believes that Man is a base creature whose only purpose in life is to help others with no thought for himself. The Order preaches social justice and entitlement, mandates charity, condemns personal excellence, and justifies murder, rape, and pillage as tools necessary to bringing 'true equality' to the masses. Unlike Richard, though, The Order doesn't bother with the truth. They instead use propaganda, misinformation, and outright lies to manipulate the masses. They demonize business owners as wealthy elitists who just want to side with Richard so they can continue to keep all the money earned for them by the common workers. They promise a new era of prosperity for the common man while punishing the 'greedy.' They use whisper campaigns to blame Richard's faction for everything that goes wrong...even natural disasters. They spread rumors that Richard doesn't care about the unemployed and would rather see impoverished children die. In short, they stoke the fire of fear in the common people.

In the end, 70% of the people vote to side with The Order. Richard withdraws his entourage and leaves the people to their fate. The Order moves in and the people discover the truth...that they have voluntarily enslaved themselves to a culture of death. From this, Richard finally realizes that truth does not automatically win every time and you can't force people to be free. He learned that no amount of logical, reasoned, factual discourse will ever change an opinion based on feelings. In fact, more often than not, the attempt to change such an opinion will lead only to animosity, derision, and outright hostility. This is where the response to my blog has left me.

As I read comments that called me things like "hatemonger", "racist", "Republican stooge", and "ignorant inbred hick", I decided I was done. Why should I even bother if just the definitions I provided were eliciting this sort of response from the effete thugs who are only interested in promoting their own agenda? It became very clear that no amount of rational, logical analysis and discussion would dent the shell of partisan intolerance in which these 'enlightened' individuals had wrapped themselves. I was done trying to be a rallying point for the vision of personal freedom and personal responsibility laid out by our forefathers. I would no longer bear that standard as long as I was viewed as nothing but a 'hick in a flyover state' by the snobs living in the elitist bastions of Los Angeles, San Francisco, Seattle, Chicago, Central Austin, and the East Coast. I had decided to drop my analysis on Healthcare in America.

This is where my brilliant youngest daughter comes in. I was discussing with her the frustration (and to an extent, depression) I was experiencing as I tried to have an intelligent discussion when she cut to the chase and asked me a single question: "Why did you start your blog in the first place?" That one question was like a lightning bolt. She made me realize that I had wandered far off track. As stated in my very first post, I started blogging "as a way to work out my thoughts on everything that is happening to our Nation and around the world." I didn't start this blog to educate or enlighten anyone else. If that happened along the way, it was gravy. But the meat of my blog is my own thoughts.

Therefore, thanks to my daughter, I have decided to continue my analysis of the Healthcare issue. I will continue to write about the facts, experiences, and opinions I deem relevant. I will continue to document my sources for my own use. I invite you to continue reading and to comment on what I post. I will probably answer questions, respond to requests for clarification, and thank you for your comments. I will not, however, debate anything in the 'comments' section of either my blog or my Facebook account until I have completed the entire series on Healthcare. Then, if you want to debate, I will do so only if you come ready with facts from verifiable sources. If you choose to try to debate anything in this series with 'feelings', I will at best ignore you, and at worst verbally shred you.

Next time, I will finally continue the series on Healthcare in America. Really! Until then...

Best regards...



© James P. Rice 2009

13 August 2009

Healthcare in America: A Clarification

Good day, family and friends!

Well, it appears that I'm on the right track. The definition I provided for American Progressivism alone generated quite a debate in Facebook...so much so that I decided I needed to clarify a few points from what I've posted so far before I go any further.

First point: the definitions I provided, specifically those for the political philosophies, are not mine. Those are the definitions provided by universally recognized experts in their fields; experts such as:

> The editors of The American Heritage® Dictionary of the English Language, Fourth Edition;

> Ronald J. Pestritto, Shipley Professor of the American Constitution at Hillsdale College;

> William J. Atto, Ph.D., American Historian and Researcher specializing in the 19th Century and Assistant Professor of History at the University of Dallas;

> Herbert Croly, founder and first editor of The New Republic.

Second point: the only personal opinion I have so far presented in this series is that the debate on healthcare in America "is rapidly devolving into shrill screaming matches split along the lines of political philosophies." As this series continues, I will make a point to indicate when I am expressing an opinion. I will also be providing a complete bibliography of my sources at the end.

Third point: I am not making this a contest between Good and Evil. I provided the definitions of the various political philosophies in order to provide a foundation for the various proposals that have been made to fix, improve, and/or change healthcare in our nation. I firmly believe it to be of the utmost importance that we understand the philosophies and motives behind the various suggestions so that an informed decision can be made.

Finally, please keep the input coming. I really do love any and all thoughtful questions, comments, and criticisms about my blog. Keep in mind, though, that if you take exception to data that I quote from a documented source, please take it out on the source and not the messenger.

Next time, how accessible is Healthcare in America?

Until then, best regards...


© James P. Rice 2009

12 August 2009

Healthcare in America: The Issues

Good day, family and friends!

As promised last time, I have one more term to define...

A-mer-i-can Pro-gres-siv-ism - noun
The political philosophy that blends socialism and fascism, originally outlined and defined by John Dewey and Herbert Croly at the end of the 19th/beginning of the 20th Centuries, and embraced by Theodore Roosevelt, Woodrow Wilson, and Franklin Roosevelt. Progressivism is a system of government marked by centralization of authority under an elite administrative class, stringent socioeconomic controls, marginalization of individual rights, limited private ownership of property, moral relativism, suppression of the opposition through terror and censorship, and typically a policy of belligerent elitist nationalism. The progressive philosophy views the common citizen as rabble incapable of self-determination and in need of guidance by the intellectual elite. Since its inception, this movement has been known as Progressivism, New Nationalism, Social Progressivism, Intellectualism, The New Deal, Liberalism, and American Progressivism.*

Some of you may be wondering why, if I'm trying to take a completely logical, scientific look at the state of healthcare in America, I'm defining so many terms that most people deem to be political. Its because one must understand the source of a problem before one can focus on a solution that actually resolves the problem and does not make it worse in the long run. The definitions of these political philosophies are important so that we can understand the source of many of the ideas being thrown around as 'solutions,' and by extension, the motive behind many of these ideas.

But the true starting point lies with the first three definitions I provided: healthcare, healthcare system, and insurance. I'm starting here because, when most people speak of 'healthcare in America,' they are actually lumping together two different issues...Access to Healthcare in America, and The Affordability of Medical Insurance (a.k.a Healthcare Coverage) in America. Therefore, my analysis and accompanying suggestions of solutions will be split into these two categories. starting with Access to Healthcare in America.

Until next time, best regards...



* Summarized definition consolidated from The American Heritage® Dictionary of the English Language, Fourth Edition and American Progressivism by R.J. Pestritto and William J. Atto.


© James P. Rice 2009

11 August 2009

Healthcare in America: Just What are We Talking About?

Hello again, friends and family!

Last time, I let you know what I mean when I use the word, healthcare, and the phrase, healthcare system. Today, I'm going to continue defining the terms of this analysis. Once again, these definitions, unless otherwise indicated, come from The American Heritage® Dictionary of the English Language, Fourth Edition*...

in-sur-ance - noun
coverage by a contract binding a party to indemnify another against specified loss in return for premiums paid.

con-ser-va-tism - noun
1) The inclination, especially in politics, to maintain the existing or traditional order.
2) A political philosophy or attitude emphasizing respect for traditional institutions, distrust of government activism, and opposition to sudden change in the established order without extensive research and due consideration.

con-sti-tu-tion - noun
1) the system of fundamental laws and principles that prescribes the nature, functions, and limits of a government or another institution.
2) Constitution: The fundamental law of the United States, framed in 1787, ratified in 1789, and variously amended since then.

fas-cism - noun
1) A system of government marked by centralization of authority under a dictator, stringent socioeconomic controls, suppression of the opposition through terror and censorship, and typically a policy of belligerent nationalism and racism.
2) A political philosophy or movement based on or advocating such a system of government.

lob-by-ist - noun
a person engaged in trying to influence legislators or other public officials in favor of a specific cause.

so-cial-ism - noun
1) Any of various theories or systems of social organization in which the means of producing and distributing goods is owned collectively or by a centralized government that often plans and controls the economy.
2) The stage in Marxist-Leninist theory intermediate between capitalism and communism, in which collective ownership of the economy under the dictatorship of the proletariat has not yet been successfully achieved.

That's all for now. Next time, one more definition, then on to the discussion.

Until then, best regards...



* The American Heritage® Dictionary of the English Language, Fourth Edition © 2009 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


© James P. Rice 2009

10 August 2009

Healthcare in America: Just How Sick Is It?

Greetings, friends and family!

One of the hottest topics in America today is our "healthcare system." No matter who you are...man or woman...young or old...rich or poor...liberal or conservative...you have an opinion on the state of "healthcare" in America...and it more often than not will be in conflict with the opinion of the person standing next to you. Unfortunately, because this is such a personal topic that affects nearly everyone at a visceral level, it is a debate that is rapidly devolving into shrill screaming matches split along the lines of political philosophies. This sort of self-serving, ego-stroking, intellectually dishonest conflict does nothing to resolve the issue and serves only to empower the 'healthcare pimps' on both sides who use the fear and uncertainty of the issue to make themselves rich.

Starting today, I want to take a clear, concerted look at the issues we're facing and see if I can't come up with some suggestions for improving the American "healthcare system." I will be using information and data from many different sources, including (but not limited to) the U.S. Census Bureau, the World Health Organization, the American Medical Association, personal experience, and the personal experiences of family and friends. At the end of the day, I believe that a reasoned, rational, intelligent plan of attack can be developed that will work infinitely better than any of the plans created by our political heroes whose primary concern is pandering to their contributors and supporters and other special interest groups.

The first thing to do is to define the problem. You may have noticed that I've been putting "healthcare" and "healthcare system" in quotation marks. This is because those two phrases can have different meanings to different people. For this analysis, here is how The American Heritage Dictionary of the English Language defines them:

health-care - noun
1) the prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical and allied health professions.
- adjective
2) of, pertaining to, or involved in the healthcare field.

health-care sys-tem - noun
the group of professionals, offices, clinics, hospitals, and other institutions concerned with the prevention, treatment, and management of illness and the preservation of mental and physical well-being.

Next time, I'll continue establishing the parameters of this discussion. Please bear with me; it will get better.

Until then, best regards...



© James P. Rice 2009

07 August 2009

30 Years and Counting - Post Script

Reunited and it feels so good.
Reunited 'cause we understood.
There's one perfect fit
And, sugar, this one is it.
We both are so excited
'Cause we're reunited, hey, hey.


- from Reunited by Peaches and Herb* (the Billboard #1 song on 22 May 1979)


And finally, I want to take a moment to thank eleven very special people:

The Reunion Committee

> Blythe Barfield Waugh

> Kelly Bohannan Dudley

> Stan Bugh

> Lisa Gregston Borger

> Kristi Herd Tackett

> Cindy Lay Ketchum

> Stacy Shields Gill

> Jeff Smith

> Jeanne Staab Jones

> Bo Summers

and the Reunion Webmaster, Kevin Wood.

Basically, these eleven souls did a stellar job of organizing and executing the 'classmate hunt' and the Reunion Weekend itself. My sister-in-law is a professional event planner and I don't think she could have done any more than you eleven did. Thank you from the bottom of my heart for a fantastic weekend! God Bless you all!

Best regards...


* Reunited © Polydor Records 1978


© James P. Rice 2009

30 Years and Counting - Epilogue

I wonder what tomorrow has in mind for me
Or am I even in it's mind at all.
Perhaps I'll get a chance to look ahead and see
Soon as I find myself a crystal ball.
Soon as I find myself a crystal ball.


- from Crystal Ball by Styx*


(Okay...I can almost hear some of you out there cheering, now that I've reached the end...)

The bottom line of these last ten posts with which I wish to leave you is this: if you have a reunion of your high school graduating class coming up, duct tape your own Captain Paranoia to a chair and go. The experience was exhilarating, refreshing, and more than a little liberating. In short, it was a blessing.


If this shadow has offended,
Think but this, and all is mended;
That you have but slumber'd here
While these words did appear.
And this weak and idle theme,
No more yielding but a dream,
Gentles, do not reprehend;
If you pardon, I shall mend.
Whilst a joyous time by me was had,
And all I saw did make me glad,
I must admit to faces missed
In this parting of Time's mist.
Jeff and Jeff and Jackie, too,
Marvelyn, I did miss you.
Patty, Cindy, Mike, and John,
I pray success has carried on.
Clark and Susan and Eileen;
Faces wished for but not seen.
Fin'ly, now, a gentle prayer
For friends of ours no longer here:
May God's sweet mercy on your soul
Waft you to your final goal.
To all the rest, I bid adieu,
With hopes to once again see you
Someday, in a future time,
When the Class of '79,
Can once again in Tulsa meet.
Until then, may your lives be sweet.

(with a tip of the hat to The Bard)

Best regards...



* Crystal Ball © A&M Records, Inc. 1976, 1988


© James P. Rice 2009

06 August 2009

A Decade (posts, not years) of 30 Years and Counting: The Show Must Go On!

The Show must go on!
The Show must go on!
Inside my heart is breaking,
My makeup may be flaking,
But my smile, still, stays on!


- from The Show Must Go On! by Queen*


When last we met, I droned on for two segments about an epiphany I'd had regarding my friends from high school. What was so interesting about that blinding flash of clarity was that, as we chatted and reminisced, a number of my friends said much the same...that they just never really felt any sort of peer pressure from their classmates. It was a wonderfully warm feeling to have my own observation confirmed.

Another interesting revelation was how some of my classmates viewed themselves during high school. One of the best examples of this is Diane.

I was in awe of Diane in high school. In my eyes (and those of more than a few of my acquaintances), she was beautiful, elegant, sophisticated, intelligent, talented, worldly, kind, eloquent, fun, inspiring...did I mention beautiful? She had traveled the world...had experienced places I dreamt of...lived in cultures outside of our own. When she was on the stage, it was like watching one of the stars of the golden age of theater. In my mind, she was the Katherine Hepburn of our generation. Imagine my surprise when, during our reunion lunch, she described herself in high school as "nerdy, clumsy, and goofy."

This was the young lady for whom I had spent most of a week working up the courage to ask her to accompany me to an awards banquet our Junior year. I was totally self-conscious the night of that banquet...afraid I would embarrass myself in front of her, while secretly basking in the pride of having such a special person as my date. Her revelation of her self-image from back then served to make that night that much more special. The fact that she felt like that on the inside while projecting the outer image I and others saw served to justify my personal belief in how special Diane is. After all, she was one of the people who inspired me to continue striving to graduate with the Class of '79.

Our lunch that Sunday, as was the entire weekend, was filled with observations and revelations such as these. I deeply believe that they have helped strengthen old friendships and create new ones amongst the Class of '79.

After several hours, we all finally admitted that we had to go our separate ways. We took a few group photos, along with a portrait of Frida Kahlo the restaurant had on display (unbeknownst to me, it was the day before the 55th anniversary of her death), and began to head out. Even then it was tough to let go...after more hugs and promises to keep in touch, several of us gathered on the sidewalk outside of El Guapo's and chatted for another half hour. Finally, we reluctantly parted and headed to our various modes of transportation. After all, the show that is our current lives must go on.

Next time, a look into the Crystal Ball. Until then, best regards...


* The Show Must Go On! © Queen Productions Ltd. 1991


© James P. Rice 2009

05 August 2009

30 Years and Counting's Ninth -or- Thank You for Being a Friend!

Thank you for being a friend.
Traveled down the road and back again,
Your heart is true you're a pal and a confidant.

I'm not ashamed to say,
I hope it always will stay this way.
My hat is off, won't you stand up and take a bow.


- from Andrew Gold's Thank You for Being a Friend!*


As I noted last time, I now know that I suffered from undiagnosed clinical depression my Senior year in high school. The reason I mentioned everything that led to my depression was so you would understand why I had all but given up on successfully completing high school. I couldn't see how to get out of the pit I was in and was on the verge of allowing the depression to paralyze me. That's where the people I've been talking about came in. Between the friends I was having lunch with at El Guapo's on Sunday the 12th, other friends I've mentioned throughout this series, and two special teachers, I (barely) managed to graduate.

I don't think any of my friends ever knew how close it had been or how important they had been to me. It wasn't because they tutored me or (God Forbid) helped me cheat, it was because of two things: 1) they provided me with living examples of what I should be doing; and 2) they never once applied Peer Pressure to me for any reason. If I didn't have two teen aged daughters of my own that had allowed me to view Peer Pressure from a father's point of view, I don't think I would have ever realized how blessed I was in high school.

During my years at Memorial, I knew people who used recreational drugs, who were a bit wild, who smoked, who skipped school, who had secret lives, who...well, you get the idea. But not a single one of those people ever put any sort of pressure on me to do what they were doing. I was offered the opportunity to join in if I wanted to, but it was no big deal if I didn't. I was blessed to be surrounded by the sweetest, kindest, funnest, most truly Cool students to ever grace a high school. Quite frankly, the obnoxiously vain crack weasels that are presented as the so-called 'cool kids' in the teen dramas from the 90's and early part of this decade aren't worthy of cleaning the toilets of those I knew in high school. That hot Sunday in Tulsa, I was lunching with the real deal.

Next time, The Show Must Go On. Until then, best regards...



* Thank You for Being a Friend © Lackyu Music, Los Angeles, CA 1978


© James P. Rice 2009

03 August 2009

The 30 Years and Counting Octopost -or- Send in the Clowns

Don't you love farce?
My fault I fear.
I thought that you'd want what I want.
Sorry, my dear.
But where are the clowns?
Quick, send in the clowns.
Don't bother, they're here.


- excerpt from Send in the Clowns, from the Stephen Sondheim musical, A Little Night Music*

While most of our classmates began their journeys home on Sunday, a dozen of us met at El Guapo's at noon for an impromptu reunion of the Masque & Gavel...and anyone else who'd been involved in the performing arts at Memorial. Like Jaimie's concert on Thursday night, it wasn't limited to the members of the Class of '79. Chargers from the Classes of 1980 and 1981 joined us for Tulsa-style TexMex, a pitcher of Mimosas, and more aerobic exercise for our memories. Beyond the hugs and smiles, the memories and updates, I began to realize what was so special about my time in high school with these people.

To set the stage for this little epiphany, let me tell you a bit about the 17 year old me. I was too smart for my own good. What this means is that, while I had the intellect that got me into the National Honor Society at the end of 9th grade, I didn't have the maturity to handle the additional responsibilities of being in high school. I had always been smart enough to make mostly A's, along with a B or two, just from the information I absorbed in class. I almost never had to crack a book. The problem with this was that I never learned how to study. By the time I hit the second half of my Junior year, I realized I was in trouble because most of my teachers were teaching "college style"...in other words, they only provided about half of the information in class and expected the students to fill in the gaps by completing outside assignments. My last three semesters were also when Real Life slapped me in the face and I was confronted for the first time with people in power (teachers) who let personal opinion and prejudices color the grades they gave me instead of going solely by my scores on assignments and tests. By Christmas break 1978, I was looking at repeating the 12th grade as a serious possibility. I didn't know it at the time, but I've since found out that I was suffering from depression I didn't know how to handle during my Senior year.

Next time, Thank You for Being a Friend! Until then, best regards...


* A Little Night Music and Send in the Clowns © Copyright Little Night Music Ltd, 2009


© James P. Rice 2009