April 2nd, 2010


A Rainy Day!

It is a day of work and reflection, refreshing files, combining and making new ones.  This spring is exquisite as all continues to ripen in the gift of rain.  I drench in scent and sound.  May we all kiss the world enough and be kissed.   Enjoy these sacred, awe-filled days.

One regret, dear world, that I am determined not to have when I am lying on my deathbed is that I did not kiss you enough.

- Hafiz
gentle waterfall

Health care -


In the New Yorker this week, in The Talk of the Town, there is a comment, "Now What?"  The article begins with President Lyndon Johnson signing Medicare into law on July 30, 1965.   Most would agree the world did not fall apart.

"In 1965, health care consumed just six percent of U.S. economic output: today, the figure is eighteen percent. Nearly all the gains that wage earners made over the past three decades have gone to paying for health care. Its costs are curtailing all other investments in the economy, and if they continue to rise as they have been doing - twice as fast as inflation - the reform's subsidies, not to mention America's prosperity, will indeed prove unsustainable."

The article continues with this:

"But the reform package emerged with a clear recognition of what is driving costs up: a system that pays for the quantity of care rather than the value of it. This can't continue. Recently, clinicians at Children's Hospital Boston adopted a more systematic approach for managing inner-city children who suffer severe asthma attacks, by introducing a bundle of preventive measures. Insurance would cover just one: prescribing an inhaler. The hospital agreed to pay for the rest, which included nurses who would visit parents after discharge and make sure that they had their child's medicine, knew how to administer it, and had a follow-up appointment with a pediatrician; home inspections for mold and pests; and vacuum cleaners for families without one (which is cheaper than medication).  After a year, the hospital readmission rate for these patients dropped by more than eighty per cent, and costs plunged. But an empty hospital bed is a revenue loss, and asthma is Children's Hospital's leading source of admissions. Under the current system, this sensible program could threaten to bankrupt it. So far, neither the government nor the insurance companies have figured out a solution."

Perhaps,  common sense.