How to Maximize Your Social Security

Suppose you’re having sex with your husband, and he happens to die, umm, sometime during the encounter. Suppose you’ve been married less than nine months – and Social Security benefits are denied thanks to some obscure nine-month rule. Well, somewhere within all the 2,728 rules is an exception applicable when death happens due to extreme exertion. The particular lady in question eventually collected benefits.

Paul Solman.wiki
Paul Solman (Wikipedia photo)

These are the sorts of stories Paul Solman weaves into discussions of his recent book (with Laurence Kotlikoff and Philip Moeller,) Get What’s Yours: The Secrets to Maxing Out Your Social Security. He wants you to catch the part about there being 2,728 rules – in case you don’t really want to read the 3,000+ pages of the document yourself. The mind can boggle at the sheer numbers. In fact, though, the rules are there to help us all, even newlyweds whose newlies do not long survive the wed. The complexity of our financial lives may be bewildering, but Solman observes, “America’s great strength is in its    complexity.”

Solman simply wants you to Get What’s Yours.

The long-time business and economic correspondent for PBS NewsHour spoke recently about his book at the Commonwealth Club of California, an event moderated by KGO TV Consumer Reporter Michael Finney. His basic message to those of us less left-brained (although Solman’s left brain clearly enjoys its coexistence with an entertainingly creative right brain) is summed up in three points:

1 – Be patient.

2 – Be aware of, and know how to maximize, over a dozen different benefits. (What you can afford, how many dependents you must consider….)

3 – Stagger your benefits.

You’re planning to retire on Social Security? Not, says Solman. “Social Security is not a retirement policy. It is an insurance policy.” But it can indeed make your retirement easier, and could be a major piece of your long-term financial plan. Solman said in an aside that he thinks most financial planners are suspect and people should be careful in choosing. “What financial planner ever advised buying TIPS (Treasury Inflation-Protected Securities,)” he asks.

Fran & Paul Solman.2
Solman off-duty, teaching a few Tai Chi moves to the writer

Three audience members already drawing Social Security each estimated his or her current payments would be at least double, if they had known earlier what they have learned from Get What’s Yours. So is the book cheating? “No,” Solman says emphatically, “you follow the rules. It’s not cheating, it’s what the law says you can do.”

One thing anyone considering eventually taking Social Security benefits can do could be to check out a copy of Get What’s Yours. Unless you’d rather study those 2,728 rules and try to figure them out for yourself.

Peaceful dying vs Doctor Knows Best

credit acpinternist.org

Barbara Coombs Lee, the sharp and articulate president of Compassion & Choices, spoke to the issue of death with dignity on PBS NewsHour tonight, with opposing views presented by Ira Byock, noted physician, author and advocate for palliative care. Neither really won; the time was too short and the issue is too complex. The Death With Dignity movement though, is not going away, and we the people will only win when the movement wins.

Lee spent 25 years as a nurse and physician’s assistant before becoming an attorney and devoting her life to personal choice and autonomy at life’s end. She believes a terminally ill, mentally competent adult should have the right to end his or her life when and how he or she chooses. Byock, chief medical officer of the Providence Institute for Human Caring, believes that if doctors were properly trained in pain management and end-of-life care – which he readily admits is far from the case – no one would ever want, or choose, to hasten one’s end. Lee appreciates the grace with which Brittany Maynard is facing her own very premature death; Byock says the active, well-educated 29-year-old is “being exploited” by Compassion and Choices.

A few caveats:

Barbara Coombs Lee is a good friend whom I admire and respect. I have worked with Compassion & Choices for well over a decade as a volunteer, Northern CA member and board chair, and now member of the Leadership Council. I strongly support physician aid-in-dying and individual autonomy.

“Hospice and palliative care,” Lee said on the NewsHour segment, “are the gold standard” for end-of-life care. But no amount of hospice care, or palliative care, can alter “the relentless, dehumanizing, unending” progression of a disease such as Maynard has and many of us will also face. For many of us, as for Maynard, there will be loss of every bodily function, one by one, quite likely accompanied by excruciating pain and possibly things like the seizures Maynard would like to minimize for her own sake as well as the sake of her loved ones who would be forced to watch.Stethoscope

Perhaps doctors will eventually all be adequately trained in pain management and palliative care. But even then – and “then” is a very long way off – must the doctor always know best? Why can’t I, the patient, the person facing my own dying, be the one in control?

Byock is dismissive of the pain involved with watching a loved one suffer agonies of prolonged dying. Maynard’s inevitably increasing seizures, for example, would be helped by palliative care, he suggested, so she wouldn’t suffer terribly. If I chose – as Maynard is choosing – to have my loved ones remember me as a woman at peace while holding their hands rather than a disintegrating person gripped with terrible spasms – why is that not an honorable choice?

Byock – who in this NewsHour fan’s humble opinion got the better time and treatment – slipped in words like “suicide” and “slippery slope” and “euthanasia,” and phrases like “euthanized in the Netherlands” too far along in the program for Lee to answer in the brief time given her. Byock ignores the fact that no one choosing to hasten death under the existing laws (four states now have the law, two others allow aid-in-dying) is committing suicide; they are being killed by their disease. No one has been, or will be, “euthanized.” The United States is not the Netherlands. He also ignores the fact that in the long years of Oregon’s successful law – it was first enacted in 1997 – there has been not one report of abuse. Not one.

There is no slippery slope. There is only compassion. Self-determination. Autonomy. Dignity. Grace. Peace. Why should they not be legal?

I respect the medical and literary achievements of Ira Byock. But I’m sorry: the doctor does not always know best.

Abortion ‘Industry’? What’s in a word?

Molécule de tenofovir
Molécule de tenofovir (Photo credit: Wikipedia)

Opponents of reproductive rights are doing pretty well with their campaign to imbed a phantom image in the public consciousness: The Abortion Industry.

Excuse me?

Dingy, windowless, cavernous rooms filled with grim-faced workers on assembly lines featuring a never-ending procession of dead babies? Add background images of a horde of grinning men and women counting their money, and you have the overall image that seems to be the goal.

Charmaine Yoest, the attractive and articulate head of Americans United for Life advanced the image considerably with her persistent references to “The Abortion Industry” during a recent appearance on PBS NewsHour. Ilyse Hogue of NARAL Pro-Choice America made a lot more sense and stuck a lot closer to facts — a large majority of Americans believe the complex decision about abortion should be made by a woman and her doctor, rather than by politicians; a probably larger majority do not believe that life begins at conception or that fetuses must have across-the-board “protection.”

It’s a catchy phrase, but the “abortion industry” is a myth.  Here’s the reality:

A virtual army of highly trained, compassionate men and women who believe in the constitutionally mandated right of a woman to make her own reproductive choices does indeed exist.

They work, often for very little pay and against daunting odds, to protect that right.

They teach, they offer advice on contraception and family planning, they counsel and console, they work to prevent sexually transmitted diseases, they serve in countless ways to make life better for men and women in need — and yes, occasionally they perform abortions.

Where, in all this, does one come up with “The Abortion Industry”?

 

 

 

Coming together: a nice idea…

About this vision thing. The Obamas and the Bidens attended a prayer service at the National Cathedral before the inauguration, at which there were mostly good wishes for national unity and progress.

But on PBS NewsHour that night one of the participants, the Rev. Adam Hamilton of the United Methodist Church of the Resurrection in Leawood, Kansas had this to say:

“I wish he had done more to reach out. In fact, that was the point of my message today at the National Cathedral was to say, you know, we need a new American vision that’s not just Democratic or not just Republican.

“It has to be a new vision that brings people together. And if we had a vision with a couple of goals, key strategic goals that Republicans and Democrats have crafted together and say this is what we’re going to work together on over the next 10 years, even though we might disagree on a whole host of other things, it would have a huge impact on bringing Americans together.”

With all due respect to Rev. Hamilton, excuse me? Four years ago, following one of the most conciliatory inaugural addresses of all time, Mr. Obama’s repeated overtures were met with the stone wall of “Our #1 goal is to see that you are a one-term president.” Which translated into unyielding opposition and previously unmatched polarization.

It would be hard to find anyone in the U.S. who doesn’t want us to come together, or wouldn’t welcome a few “key strategic goals that Republicans and Democrats have crafted together.” But our President didn’t get a lot of help the first time around (remember Bowles-Simpson?)

So now reality has set in, expectations are lower and strategies a little less conciliatory — but Obama’s vision is still there.

A 3x2 stitched and HDR tone mapped image of th...
A 3×2 stitched and HDR tone mapped image of the sanctuary at the National Cathedral in Washington, D.C. (Photo credit: Wikipedia)

Where there’s vision, there’s hope.

How smart is your phone, really?

telephone
telephone (Photo credit: Sean MacEntee)

Is your phone smarter than you?

Smarter than both of us?

Gadget guru David Pogue‘s phone outsmarted the thief who unwisely lifted it on a train whizzing along the northeast coastline. Pogue, as reported in an interview with PBS NewsHour‘s Jeffery Brown, arrived in New York minus his phone, and immediately set to work tracking it down. With a little help from an app or two, he located it somewhere in Maryland. Then, with a little more help from Google maps and a million+ Twitter followers, he located the precise house where the hapless thief and his booty were holed up. A few astute policemen eventually heard the loud beeps that Pogue was instructing his phone to emit, scooped up their prey from deep in the grass of the back yard and started it on a journey home. The thief got off lightly — Pogue and cops all being more interested in bringing the whole interstate adventure to a close than in filing a lot of time-&-labor-intensive papers. But for a while he’ll probably stick to wallets.

My phone is not quite that smart. But I do, after intense pressure from friends and relations about the age of Pogue — whose grandmother is about my age I would guess — now have a smartphone. It may not be smart enough (or app-loaded enough) to help me find it if someone snatches it, but it is smart enough to do a LOT of things I am not smart enough to ask. Yet.

I bring all this up because I increasingly believe all that stuff about Boomers and geezers being incapable of adjusting to the age of technology is hogwash. Before becoming a smartphone owner, OK, maybe I believed. Now? Nahh. Now that I have successfully installed our new computer modem, reconfigured the router (take that, $89/hr Geek Squad) to get us back online a couple of weeks ago, fiddled around with the background color of this emerging blogsite and made a few moves with my smartphone……. all things are possible.

And anyway. David Pogue wasn’t smart enough to avoid getting his iPhone snatched. I don’t think he even has a BA in Art or an MFA in Short Fiction.

The bewildering curse of face blindness

You have trouble remembering a name? Imagine being unable even to remember a face.

Oliver Sacks, the remarkable physician/writer/author/professor of neurology — what does he do in his spare time? — wrote a long and fascinating article in a recent (August 30) New Yorker in which he details a lifelong affliction with face blindness, officially known as prosopagnosia, the inability to recognize faces. What Sacks doesn’t do in his spare time is socialize comfortably. It’s hard to be comfortable when you might walk right past your best friend. (Or greet a perfect stranger you think is your next-door neighbor.)

I had made it through seven decades (Sacks and I happen to be the same age, but that’s about where the similarities end) without ever hearing of face blindness. Then one day renowned artist Chuck Close turned up on PBS NewsHour, discussing a new biography. At some point in the program Close mentioned that he was face blind. Come on, I said to myself and the TV screen. A creative genius known worldwide for, among other things, his remarkable portraits and he doesn’t know faces? Close went on to talk of how he works from photographs, largely because once he reduces a face to two dimensions he can commit the image to memory.

Sacks theorizes that the “flattening” allows Close to memorize certain features. “Although I myself am unable to recognize a particular face,” Sacks writes, “I can recognize various things about a face: that there is a large nose, a pointed chin, tufted eyebrows, or protruding ears.” But he is better at recognizing people by the way they move, their “motor style.” He is “reasonably good at judging age and gender, though I have made a few embarrassing blunders.”

Sacks writes that he avoids parties, conferences and large gatherings as much as possible in order not to have the inevitable embarrassment it brings. Consideration of how difficult it has to be to negotiate through life with such a problem makes the common complaint of, say, blanking on an old friend’s name (and don’t we all!) so trivial as to be embarrassing itself.

Sacks cites the work of research scientist Ken Nakayama, who “is doing so much to promote the scientific understanding of prosopagnosia.” Nakayama heads the Prosopagnosia Research Center at Harvard, on whose Web site one can learn about symptoms, causes, history and where the name came from (the Greek word for face: prosopon.) You can also find, on the site, tests and questionnaires to assess your own face recognition. Sacks is particularly appreciative of a notice posted on Nakayama’s own site which reads: “Recent eye problems and mild prosopagnosia have made it harder for me to recognize people I should know. Please help by giving your name if we meet. Many thanks.”

A very small gesture, for those who take face recognition for granted.

Supreme Court leaves 'Healthy San Francisco' program to its own success

Healthy San Francisco, the city’s healthcare-for-all program, remains firmly in place after the Supreme Court’s dismissal of a suit by the Golden Gate Restaurant Association last week. It may or may not be the model for everywhere else, but a lot of reassured folks here are happy with it. Many are also healthier in the bargain. PBS NewsHour correspondent Spencer Michels talked with several Healthy SF participants for last night’s report, while outlining how the program is working.

Until recently, San Francisco, a diverse city with a population of nearly 800,000, had more than 60,000 adult residents with no health insurance. They were not poor enough for Medicaid, nor old enough for Medicare.

While the nation struggled with reforming health care, this city began a program of its own that so far has enrolled more than three-quarters of its uninsured. It’s called Healthy San Francisco, and it is not, strictly speaking, health insurance. Rather, it’s a way to provide health care, but only within the city limits.

The plan was not particularly radical. It used mostly existing resources, like city clinics and nonprofit hospitals, to supply and coordinate care. Instead of flitting from one clinic or emergency room to another, enrollees choose a medical home, one of 30 public or private health centers in the city, where they go for low- or no-cost health care.

Once you choose your “medical home,” you can’t walk into another and get treatment. But the two Healthy San Francisco participants this writer asked (along with the patients and clinic directors Michel featured on the PBS show) indicate that customer satisfaction with the system — and with their one medical home — is high.

As to the costs, and who covers them, most San Franciscans other than the restaurant owners are fine with the plan. Restaurant-goers have gotten used to the friendly, small-print message at the bottom of the menu that lets them know an amount added to the tab goes to help pay for Healthy SF.

Each patient in Healthy San Francisco costs the city about $300 per month. That’s in line with insurance costs. It totals $126 million a year.

Depending on their income — and most are below the poverty level — enrollees pay nothing or from $20 a month up to about $200, plus co-payments. But that doesn’t pay for it all. The city has mandated that businesses with 20 to 100 employees spend at least $1.23 an hour per worker for health care, and that larger companies pay more.

That money can be used to reimburse employees for health care costs, to buy them health insurance, or it can go to Healthy San Francisco.

The Restaurant Association’s argument before the Supreme Court was not on Constitutional grounds, but rather that the city’s mandate that employers pay into the program violated federal law. The Court declined to deal with it all; the mandate stays. Susan Currin, CEO at San Francisco General, says emergency room use is slightly down. Director Hali Hammer of San Francisco General Hospital Family Health Center (one of the more popular medical homes) says they have hired new providers and expanded hours. The number of participants is growing at about 700 per week, and the Kaiser Family Foundation recently found that 94 percent of those participants are satisfied with the program. Paying that small extra amount for dinner out makes at least a few of us occasional diners-out feel a slight good-citizen glow. Something’s working.

San Francisco Ramps Up Care for City’s Uninsured | PBS NewsHour | Oct. 12, 2009 | PBS.