Category: Politics & Causes

Money/Politics & Causes/USA
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Saying Goodbye to Ken Lewis

by Fran Johns

I am not sorry to see Ken Lewis leave his cushy Bank of America post. This has nothing to do with understanding what’s really going on at BofA, or the economy, or finance in general. It has to do with the frustrations of middle America, to which I belong. Especially aging middle America.

When my father died in 1987, leaving small amounts of his hard-earned estate to his daughters, I put a little of my small amount into a small-town bank stock. Eventually that bank was bought by a bank that was bought by BofA. Nice. My stock increased from very tiny number of shares to very small number of shares — but still enough to give me a couple hundred dollars every quarter and pay off my church pledge with the shares of which I now have more than my extensive portfolio should have. (I don’t understand any of this either, but am fortunate to have an in-house economic advisor.)

Yesterday I received my dividend check, in the amount of slightly over $4. Lord only knows what my shares are worth, if anything. I am very lucky to be healthy and still in the workforce more or less, and not reliant on my personal investment portfolio.

Not long ago there was a story in the New York Times about a woman my age, widowed a few years ago, now having to move in with her son because she and her husband had done exactly the same thing: invested in their small-town bank in order to have investment income for her to live on. It was bought by a bank that was bought by BofA. With the fall of BofA, she could no longer afford to pay the bills and was about to lose her house. I remember thinking how easily she could be me.

Now we read (New York Times October 1) that Mr. Lewis “is fed up with the criticism” about his buying Merrill Lynch. And that he returned from vacation in Aspen with a full beard to announce his resignation. Well poor, poor Mr. Lewis.

Middle America used to trust its bankers. Mine, earlier, was named Mr. Trivett and he advised me to put $10 into savings for every $100 I was ever able to accumulate. Another, earlier, was named Mr. Harris and he once wrote a personal letter to my daughter advising her to keep her college grades up because she needed to justify the loans he had backed for her.

Somehow I missed out on that sort of a relationship with Ken Lewis. Somehow the banking industry has lost that connection — any connection at all — with its consumers. And its everyday shareholders. And other things like accountability and consideration and good, honest business practices.

I wish Ken Lewis could know what it feels like to be unable to pay the bills.

General interest/Health/Money/Politics & Causes/USA
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Will Anti-Abortionists Sink Health Reform?

by Fran Johns

Already the right wing, Catholic officialdom and Sarah Palin have won their battle to make sure that I, and countless other millions, will likely die only after expensive, prolonged, futile, aggressive, undesirable treatment rather than peacefully at home as I choose. Now they want the generations younger to be sure that any accidental, criminal or otherwise unplanned pregnancy results in another unwanted child coming into this overpopulated world. An assault on health reform is their latest battleground. I am careful to say Catholic officialdom, because all of the lay Catholics I know, many of them Good Catholics, support both reproductive and end-of-life choice. I am careful to mention Sarah Palin just to prove I have absolutely no resentment over the fact that whereas I can’t interest publishers in my several excellent book projects, she has a planned first run of 1.5 million on her dashed-off memoir.

But back to the problem at hand. Writing in Tuesday’s New York Times, David Kirkpatrick presents the new scary problem:

As if it were not complicated enough, the debate over health care in Congress is becoming a battlefield in the fight over abortion.

Abortion opponents in both the House and the Senate are seeking to block the millions of middle- and lower-income people who might receive federal insurance subsidies to help them buy health coverage from using the money on plans that cover abortion. And the abortion opponents are getting enough support from moderate Democrats that both sides say the outcome is too close to call. Opponents of abortion cite as precedent a 30-year-old ban on the use of taxpayer money to pay for elective abortions.

Abortion-rights supporters say such a restriction would all but eliminate from the marketplace private plans that cover the procedure, pushing women who have such coverage to give it up. Nearly half of those with employer-sponsored health plans now have policies that cover abortion, according to a study by the Kaiser Family Foundation.

Never mind that Obama has promised that no federal funds will go for elective abortions, and the current policies would remain unchanged, here is a handy opportunity to make points with conservatives and throw a monkey wrench into the works of reform.

Lawmakers pushing the abortion restrictions say they feel the momentum is on their side, especially because the restlessness of other Democratic moderates is making every vote count.At least 31 House Democrats have signed various recent letters to the House speaker, Nancy Pelosi, urging her to allow a vote on a measure to restrict use of the subsidies to pay for abortion, including 25 who joined more than 100 Republicans on a letter delivered Monday.

Representative Bart Stupak of Michigan, a leading Democratic abortion opponent, said he had commitments from 40 Democrats to block the health care bill unless they have a chance to include the restrictions.

So it’s all about halting abortion — maybe — or all about halting reform — maybe — but some of us who simply, desperately, wish better care and a few decent options for our less-advantaged citizens are left to wonder what it’s really all about.

Abortion Fight Complicates Debate on Health Care – Readers’ Comments – NYTimes.com.

General interest/Health/Money/Politics & Causes/USA
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Hanging in the 'hood – a good option for boomers and beyonders and the economy

by Fran Johns

Say you’re happy in your ‘hood. The sights are familiar, the neighbors are okay, the comfort level is high. Now say you’re 70-something or 80-something and you need a little help now and then, bringing in the papers, getting to doctors’ appointments, changing light bulbs. Do you really want to pull up roots and move to a totally new environment, re-learn where everything is, make new friends among people who never knew your children (or your parents)? The latter is being chosen every day for or by seniors in America; the former is spurring a movement with an interesting variety of formats under the general heading of Aging in Place. I really want an umbrella acronym for this category, but I don’t really want to be an AIP.

On her New Old Age blog for the New York Times a few days ago Paula Span wrote about her dad’s life in a NORC.

In my father’s apartment building in South Jersey, the older tenants start drifting into the small lobby each day around 1 p.m., taking up positions on chairs and couches. The ostensible reason: The mail is about to arrive. The real reason: They relish a chance to schmooze.

“There’s a lot of discussion about the economy,” Dad reports. “And what the president said about the police and that fellow in Massachusetts.” Lesser issues arise, too. Whose daughter is coming to visit. What is on sale at the ShopRite supermarket.

Twenty-five years ago, a University of Wisconsin professor coined a great term for this kind of residence. It is a naturally occurring retirement community, or NORC. The place wasn’t built for seniors; its tenants are all ages, infants through nonagenarians. But a substantial number of residents have been there long enough to grow old together.

Since he still drives, my father heads out each morning to buy the papers, which get passed from one apartment to another. (God forbid you should squander 50 cents for your own copy and read the headlines before suppertime.) He ferries friends to doctors’ appointments. He benefits, too: his pal Manny comes by several times a day to check on him, and neighbors stock his fridge with soup and strudel.

NORCs exist all over; probably half of Miami Beach, Fla., was a NORC at one time. Watching this little community cope with shopping and banking and constant medical visits, I have wondered why services can’t be brought to these residents. Wouldn’t it be more efficient to have a nurse visit weekly, instead of each person making a laborious trip to a doctor’s office? For the senior van to schedule regular excursions to ShopRite? For the high school orchestra to give concerts in the community room, since so few older residents go out after dark?

A number of NORCs do offer this kind of help. Twenty-five states have NORC supportive service programs, according to the queen of NORCs, Fredda Vladeck, who runs the United Hospital Fund’s Aging in Place Initiative. New York leads the list with 54 NORC programs operating in high-rises, garden apartment complexes and neighborhoods of single-family homes; Indiana comes in second. The common mission of the programs, Ms. Vladeck said, is “transforming communities into good places to grow old.”

NORC’s and their cousins the Village aging-in-place concepts are multiplying, but they’re nothing new. They’ve been around for more than a quarter of a century (if you discount the automatic NORCs that small towns and Native American communities offered in ancient America afforded. And they’re proven effective. “Numerous studies have documented the benefits and potential of NORCs, including a Senate report (PDF), a foundation grant report and a graduate thesis,” Span writes.

So why, after 25 years’ experience, are there not more support programs for the millions of older Americans already living in NORCs, and the millions more to come?

Ms. Vladeck, accustomed to lobbying and testifying and organizing, sounded philosophical. “It’s incubating,” she said. “Sometimes, innovation takes a long time.”

If you want to keep your parents out of nursing homes, or want to stay out of a nursing home yourself, learning about how these alternatives work isn’t a bad way to start the plan.  There may not be a long time left, at the rate America’s getting older.

When the Neighborhood Is the Retirement Village – The New Old Age Blog – NYTimes.com.

General interest/Health/Money/Politics & Causes/USA
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Jail time for texting drivers

by Fran Johns

The life you save may be your own… or possibly mine. Right now, to be honest about it, I am more interested in mine. And mine is regularly at risk from texting drivers.

Today’s front page story by Matt Richtel in the New York Times, with accompanying photo of large driver of large vehicle, small dog in his lap and intricate computer screen to the right of his steering wheel, raises more fear in me than local jihadidsts and prospective death panels. The latter are abstract &/or untrue, the former is real. And preventable. “We are supposed to pull over,” trucker Kurt Long says blithely, “but nobody does.” Richtel also quotes American Trucking Association spokesman Clayton Boyce as saying that truckers “… are not reading the screen every second.” Why is this somehow not comforting?

I concede that time is critical to drivers of large vehicles. But at some point the public good ought to prevail. Those of us over 60 are admittedly better able to remember when it was possible to live without texting (or even cell-phoning) while driving and thus better able to think it could be possible again, at least on a limited basis. We are also able to remember when it was convenient for some people to drive around very drunk and occasionally kill people, before laws were passed to limit that activity. Driving a big rig while texting may seem more important than driving blotto after a party, but the dead are just as dead. Somebody has got to get the attention of our legislators — somebody not indebted to the very powerful trucking industry lobby — so that new laws are enacted.

Walking, whenever time and public transportation permit, is my mobility of choice. On foot, I regularly notice the drivers who don’t notice me because they are too busy texting or talking on cell phones. Pedestrians learn to do this. But if you’re driving down the highway and a large vehicle is barreling toward you or near you, propelled by a minimally-attentive driver, you don’t stand a chance. And I say, send them to jail.

Beloved members of my immediate circle of family and friends have been known to text while driving. I still say, send them to jail. I’ll come visit.

General interest/Health/Money/Politics & Causes/USA
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Boomers & the high cost of dying

by Fran Johns

As health reform slogs along, a few critical pieces are already gone for good — or for now, at least. One of the saddest is coverage for end-of-life conversations; one of the saddest elements of our culture in general and healthcare mish-mash in particular is the tendency to treat death as a curable disease. Timothy Egan, in a recent blog for the New York Times, makes an eloquent case for injecting a little reality into all this.

In the last days of her life, Annabel Kitzhaber had a decision to make: she could be the tissue-skinned woman in the hospital with the tubes and the needles, the meds and smells and the squawk of television. Or she could go home and finish the love story with the man she’d been married to for 65 years.

Her husband was a soldier who had fought through Europe with Patton’s army. And as he aged, his son would call him on D-Day and thank him – for saving the world from the Nazis, for bequeathing his generation with a relatively easy time.

That son, John Kitzhaber, knew exactly what his mother’s decision meant. He was not only a governor, a Democrat who served two terms in Oregon as it tried to show the world that a state could give health care to most of its citizens, but a doctor himself.

At age 88, with a weak heart, and tests that showed she most likely had cancer, Annabel chose to go home, walking away from the medical-industrial complex.

“The whole focus had been centered on her illness and her aging,” said Kitzhaber. “But both she and my father let go that part of their lives that they could not control and instead began to focus on what they could control: the joys and blessings of their marriage.”

She died at home, four months after the decision, surrounded by those she loved. Her husband died eight months later.

The story of Annabel and Albert Kitzhaber is no more remarkable than a grove of ancient maple trees blushing gold in the early autumn, a moment in a life cycle. But for reasons both cynical and clinical, the American political debate on health care treats end-of-life care like a contagion — an unspeakable one at that.

Kitzhaber, having seen the absurdities of the system — Medicare would pay hundreds of thousands for continuing treatments but not $18 an hour for an in-home caregiver to help her die as she chose — was among the thousands of us who were distressed to see the debate get sidetracked by misinformation and outright lies. He knows the truth: that changing the way we treat dying people is the only way real economies and compassionate reform will happen. He is not only a politician, currently running for a third term as governor of Oregon, the state that has shown us the way, but a physician. And he’s smack in the middle of the Baby Boomer generation. Egan cites the recent Newsweek cover article by Evan Thomas, “The Case for Killing Granny,” and its on-target line about this being the elephant in the room, “Everybody sees it, but nobody wants to talk about it.

John Kitzhaber, M.D., politician, and son who watched both parents die in a dignified way, cannot stop talking about it. His parents’ generation won the war, built the interstate highway system, cured polio, eradicated smallpox and created the two greatest social programs of the 20th century — Social Security and Medicare.

Now the baton has been passed to the Baby Boomers. But the hour is late, Kitzhaber says, with no answer to a pressing generational question: “What is our legacy?”

The Way We Die Now – Timothy Egan Blog – NYTimes.com.

General interest/Health/Money/Politics & Causes/USA
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Pills vs. Time: The Power of Patience

by Fran Johns

Another interesting article about slowing down our rush-to-treatment healthcare mentality (see Pills & Perils below) appeared in Tuesday’s ‘Personal Journal’ section of The Wall Street Journal. This one is a lot simpler: do nothing, just wait. WSJ‘s Melinda Beck is writing less about serious afflictions than about the minor problems that plague us all; still it points once again to our cultural tendency to Do Something, whatever it is.

What cures colds, flu, sore throats, sore muscles, headaches, stomach aches, diarrhea, menstrual cramps, hangovers, back pain, jaw pain, tennis elbow, blisters, acne and colic, costs nothing, has no weird side effects and doesn’t require a prescription?

Plain old-fashioned time. But it’s often the hardest medicine for patients to take.

“Most people’s bodies and immune systems are wonderful in terms of handling things—if people can be patient,” says Ted Epperly, a family physician in Boise, Idaho, and president of the American Academy of Family Physicians.

“I have a mantra: You can do more for yourself than I can do for you,” says Raymond Scalettar, a Washington, D.C., rheumatologist and former chairman of the American Medical Association. But, he says, “some patients are very medicine-oriented, and when you tell them they aren’t good candidates for a drug they’ve heard about on TV, they don’t come back. I have colleagues who say, ‘You can take this pill and get better in two days, or do nothing and get over it in 48 hours,’ ” says Dr. Scalettar.

Of course, we know this. Most of us have some genetic strain of either the leave-it-alone-it’ll-be-better-in-the-morning or the shut-up-and-tough-it-out approach to all aches and pains. But we also have those constant messages from the TV set, and increasingly from the computer screen, that say one little pill will make it all better, right this very minute. And we are a right-this-very-minute society.

Almost all viral infections resolve on their own, unless you have a compromised immune system. As a rule of thumb, Dr. Epperly says, infections in the nose, throat, stomach and upper respiratory tract tend to be viral. Infections elsewhere in the body are likely to be caused by bacteria, and those can get worse without antibiotics. About 80% of urinary-tract infections resolve on their own, for example, but about 20% develop into more serious kidney or blood infections. And even if they don’t, the symptoms can be very uncomfortable.

Some chronic maladies follow predictable courses, according to many medical experts ,whether or not they are treated.

Colic is almost always gone in four months. Some 70% of acne is gone three to four years after it first appears. “Frozen shoulder”—a painful restriction of the shoulder joint—is typically painful for three to six months and stiff for the next four to six months, and resolves completely after one to three more months. Temporomandibular joint (TMJ) pain tends to go away by itself in 18 months. Sciatica resolves on its own in three weeks in 75% of cases.

Not many of us do pain and misery very well. As a repeat TMJ sufferer, I can promise you if I tried to wait it out without pain killers for 18 days, let alone months, my entire neighborhood block would evacuate. Pain (see Caitlin Kelly’s Broadside post a few hours ago) is in a category all its own. Actually, though it is hell to pay, sometimes it can serve a purpose. My good husband wound up in the emergency room with a gall bladder infection that would’ve had anyone else, surely including myself, shrieking in agony; he does not feel pain. That is great when you’re young and macho, not so good when you get a few years on you and could use a signal that something’s wrong.

But for the minor issues, things wrong can often right themselves without outside interference. Now… if I could only start over again with everything I should or shouldn’t have taken…

When Doing Nothing Is the Best Medicine – WSJ.com.

General interest/Health/Money/Politics & Causes/USA
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Some Women's Views of Health Reform

by Fran Johns

First Lady Michelle Obama is making the news in support of her husband’s health plan, hoping to tap into the energies of one group who voted for Obama in large numbers: women. Reform is everyone’s concern, but in many ways it occupies a specific gender niche. As reported by Voice of America’s Kent Klein,

Mrs. Obama says health care reform is a women’s issue. “Women play a unique and increasingly significant role in our families.  We know the pain, because we are usually the ones dealing with it,” she said. The first lady spoke Friday to a gathering of women near the White House, and said the state of the U.S. health care system is unacceptable. “For two years on the campaign trail, this was what I heard from women:  That they were being crushed, crushed by the current structure of our health care.  Crushed,” she said.

A host of women’s groups, blogs, newsletters and web writers have also recently joined in. Posting in the National Women’s Law Center blog, Outreach Manager Thao Nguyen told the poignant story of hearing from a friend that she’d just married her long-time hesitant boyfriend. The marriage news was good news, but its terms took the joy out: having lost her job, it was the only way she could get health insurance.

Her point seemed so logical, but the entire idea was couched in such an insane reality I was simply speechless. Lucy is in her early 30s but she has a pre-existing condition so buying individual health insurance and the unfair, overpriced premiums that come with it was out of the question. Lucy has been living with Dan for 10 years, but unfortunately, he works for a company that doesn’t offer domestic partner benefits.

I couldn’t help but think: is this what our broken, unstable health care system means for millions of Americans around the country? As the economy continues to struggle, employers continue to shed jobs, and every day 14,000 more Americans wake up realizing that they are now uninsured and just one illness away from financial ruin. Are reluctant bachelors around the country going to put away their Megan Fox posters, cancel the “poker nights” (aka X-Box marathons we’re on to you), and start settling down?

My own run-in with healthcare weirdness is minor in comparison to most, but I still remember the shock. Making a routine call to renew the prescription for a bone-building drug I had taken for years to stave off osteoporosis, the message center person said she probably should warn me that rather than the $24 co-pay I’d been having per quarter my cost would now be $230. I do need these bones, but couldn’t see them worth $920 a year. I hung up and started drinking more milk. Had to get breast cancer, for which I now take a covered post- cancer drug which my oncologist prescribes… mainly to keep my bones healthy. Something is bizarre here.

Or maybe we women might bend the old macho adage a little: It’s broke, fix it.

VOA News – Michelle Obama Joins Health Reform Campaign.

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