Barrett Rainey's Second Thoughts

One of the rare advantages to living with some 90,000 seniors in adjoining communities is the great health care. Family docs and specialists for absolutely everything. On every corner.

Three months ago, we needed the services of one of those specialists for back surgery for Barb. Reamed off the arthritis that had grown on her lower spine, rebuilt the base that had dissolved and inserted eight screws to hold it all together. No followup prescriptions. No pain. Just some rehab in an excellent facility. As I said, “great health care.”

Since we’ve received no bills in these 12 weeks, we got to wondering what total charges were and what Medicare and our secondary insurer paid. So, we got online and checked it out.

Because the charges were many, involving nearly a dozen providers – some we’d never heard of – and a lot of descriptions were puzzling, we had to go piece-by-piece to see who got what.

Ironically, the surgeon was less than $10,000. We’d expected higher. Hospital charges were divided into a couple dozen categories which included other specialists and their attendant equipment. Hard to put a dollar figure on her five-day stay but I’d guess another $20,000.

Then, there was a seven-day stay in a rehabilitation clinic with more docs and therapy sessions twice a day. Great place that produced good results. And she was issued some specialized rehab equipment.

But, here’s the kicker. Medicare is showing a total charge of nearly $240,000! Almost a quarter-million bucks! Unbelievable. But, that’s what it says on the page. How the numbers went from $30-40,000 to $240,000 we can’t figure out. But, that’s what it shows.

In actuality, it appears Medicare paid about 80-percent of something and the “medigap” insurer paid about 20-percent of what we figure was the approximate balance. And, as I said, we’ve received no other billings. Wanna talk to me about “socialized medicine?”

Medicare is under continuous audit, so they’ll get around to our account one of these days. But, it’s kinda like living under a Sword of Damocles. Will we open the mailbox one day and find a six-figure bill? Or, will the hospital and all providers, who also audit accounts on a regular basis, find errors and shower us with surprise charges? Or, do the feds use some curious mathematics known only to them? We’ll let you know how things shake out in a couple of months. So far, not a dime out-of-pocket.

Then, there’s this. A couple of weeks ago, the CEO of Idaho’s St. Luke’s health care empire announced his retirement. On his way out the door, he came up with this bon mot: “The nation has to move away from fee-for-service health care.” Read that again. “The nation has to move away from fee-for-service health care.”

Now, here’s a guy who’s spent the last decade atop Idaho’s largest hospital system making, I’m certain, a healthy six-figure salary. In retirement, I’m equally certain, he’ll probably have a healthy six-figure income. And, as he’s leaving a life’s career in fee-for-service medicine, he now admits it’s all wrong?

He’s right, of course. The U.S. is about the last industrialized nation using fee-for-service. Many countries, with far smaller economies, provide quality care for all with different systems. We should, too.

One of the things about our current cast of Democrat presidential wannabees that irritates me are promises of a “better world” if all we do is pick one of them. Road apples, as Col. Potter often exclaimed!

Stop promising free this-and-that, concentrate on the middle ground and deal with issues of real substance: healing divisions, making government a servant rather than the master its become, school shootings, poverty, universal health care, deal with the national economic imbalance, overhauling defense funding, etc..

Congress holds the nation’s purse strings. Presidents can only propose. Congress, alone, decides how much will be spent and on what. All this candidate chin music amounts to nothing, no matter how worthy the cause, if Congress doesn’t write the check. Period.

And, there’s this. Today’s workers will not have jobs for 30-40 years with the same employer that end in retirement unless they’re in a very large corporation. In fact, we’re told many on the job today will change careers half-a-dozen times or more which means they need retirement and health care plans that move with them. Fee-for-service care and the accompanying health insurance costs will eventually get too high for most people which means more uninsured care. And, that’s damnably expensive!

So, where are we? Well, at our house, we’re anxiously awaiting what could be a six-figure medical bill. Or not. A highly-paid Idaho health care executive says we must change the way we charge – and pay – for health care. Or not. Political campaigners are “promising the moon” on all sorts of things they want you to believe. Or not. And our traditional employer-provided health care days are numbered so we’ve got to change the system. Or not.

Other than that, have a nice day!
 

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Well, here we are. All wrapped up in this impeachment business. Almost nothing in the news these days except all the activity in the U.S. House and the serial lying, character assassination and a steady stream of verbal sewerage coming out of the White House daily.

There’s not much guessing about the outcome of the issue. Looks like Speaker Pelosi has the votes and I’ll bet she figures, when push comes to shove, a few Republicans will even join the Dems. That’s all well and good, having the votes in your pocket. And it appears she does.

With any luck at all, the House will do the deed and pass the “Bill of Impeachment” over to the Senate before Christmas. First, they’ve got to contend with some GOP reps – the crazies – and all the baseless B.S. in which they’re engaged.

But, I’m already looking a step ahead to the Senate. And I have a question. Given the long, wide and deep political divisions in that chamber, can there be a fair impeachment trial? Seriously.

As I recall, in the other two such trials in my lifetime, leaders of both parties put differences aside and got their heads together – in secret – to draw up a set of rules for how the trial would be conducted in those formerly hallowed halls.

Again, with the angry, highly partisan feelings, the personal attacks and the rancor that exists in almost every vote on other issues in the Senate these days, is it really possible for folks in leadership of the two parties to agree on such an absolutely necessary basic issue?

And there’s this. What if they can’t? What happens then? Does the whole thing just die? Is it all over? No trial?

No one seems to have the answers to any of those questions. There’s a lot of “chin music” going on but I haven’t seen any assurances “leadership” can rise to the occasion. Rather than getting together, it seems there are almost direct efforts to keep the divisions open while pouring a verbal salt in the wounds.

Example. One of the most historic and practiced tenets in Congress is that no one in either body will publically speak disparagingly of a member in the other body. Not even mention a name.

So, here we have a “senator” from Louisiana, with a mouth larger and quicker than his brain, publically naming Speaker Pelosi, saying for all to hear, “It must suck to be as dumb as she is.”

Coming together? Observing rules and protocols? Overcoming ingrained political and personal divisions for the common good? Trying to at least get along while Congress deals with this most serious impeachment business?

You’ve got GOP crazies – and a know-nothing President – “demanding” the whistle blower not only be named but forced to testify in the impeachment hearing. Strictly against federal law. Won’t happen. The same bunch has already been attacking the credibility of witnesses. The “credibility” of these witnesses? Really? Good luck with that.

And, across the rotunda, you’re got the chairman of the Senate Judiciary Committee saying there are no grounds for impeachment and he won’t be reading the testimony of witnesses who testified before House committees. Nor, he says, will he watch the televised public hearings. A lawyer by education, a retired Army Judge Advocate in the Reserves, and the chairman of the most germane Senate committee calls impeachment “a scam” and he “won’t read the under-oath witness statements?” Comity? Coming together?

And there’s Ol’ Mitch. He’s already said Republicans will “take a responsible lead” and the trial “shouldn’t last longer than five or six days.” Then, he thought a bit and prophesied it “could take longer” when he figured out six Democrats running for President could be taken off the campaign trail for weeks with an extended “trial.”

There’s a whole lot of lawyers sitting in those Senate chairs. They’re the folks who’ll be the “jury” for the process. They’re going to be sworn in as “jurors” beforehand with an oath that requires “an open mind” to the testimony and other evidence to be presented.

Idaho has two of those “jurors.” Have you listed to either of them lately. “I’ve seen no evidence that rises to the level or impeachment,”
they’ve said, or words to that effect. Others of their political “persuasion” have uttered similar statements. You’re going to find 67
Senators with “open minds” in a “jury” pool like that? And the chairman of the Judiciary Committee calls the process “B.S.?”

So, the question is, again, what happens if they can’t get their act together? How do you find 67 votes for any honest verdict given the words, pre-judgement and dismissals already on the public record?

The impeachment process rests on the U.S. Constitution and is about the most important issue to be dealt with by the 537 members of any Congress. The process, as in any other judicial proceedings, requires honesty, thoughtful consideration of all testimony, all witnesses and other evidence with an open mind.

Do those things seem possible in the chaos of hate and division extant in our Congress? They’re absolutely necessary to a fair trial and a just verdict. That’s how they’re supposed to approach this.

But, can they? Will they?

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All my life I’ve been told “change is constant.” And, all my life – 80+ years – it has been. In nearly all ways. But, just because it’s a “constant” doesn’t mean it may always be good change.

I recently got some medical news that’s made me reflect a bit and take note of some of that “change.” For much of it, I’m not happy with the review.

The media has changed. As someone who spent a good portion of his life embroiled in it, that change has been one of my greatest disappointments. In so many ways.

For one, nearly all media outlets turn off the lights Friday evening and don’t show up till Monday morning except for weekend sports. We live in an area of about 4-million souls, “served” by a lot of media outlets. Still, this week, an airplane crashed locally Saturday morning and there was no account of it – or the deaths involved – until Monday mid-day. Anywhere.

Newspapers – and even some broadcast outlets – routinely “report” a story with the words “…according to a news release” prominently displayed. Might be a mainline water break or two 18-wheelers meeting head-on or a jailbreak. Makes no difference. Wait for the news release. Even in our 4-million+ market.

Don’t get me started with spelling errors, wrong picture ID’s, words dropped from sentences or headlines, an over-abundance of “fluff” and a neglect of real news.

Coarseness in our language is another disappointing “change.” Been to a sporting event lately? Or a restaurant? Even movie theaters. Or how about Facebook? Have you listened to teens – or 2nd graders – talking? Sounds like a coal miner’s workplace. Even network TV shows and some of our political speeches. Lots of #/@+.

Churches have changed, too. You can find a good number these days with “answers” to your every question. The historic, individual search for faith and connectedness is now too often met with “our way or the highway.” Some even try to overrule laws or political principles with their narrow, self-serving views of things “religious.”

Adherence to laws has, for far too many, become old fashioned. Especially on the highway. Rules of the road seem to be thought of as “suggestions.” “I’m here and I’m going there so get out of my way.” See it everyday.

Lots of disturbing “changes” in law enforcement as well. Elected, professional lawmen refusing to enforce one or more laws they don’t agree with, cherry-picking what they see are acceptable ones and ignoring those they don’t like. Or, ones that might have a bearing on their next re-election campaign.

There are many more examples of changing social norms and customs that aren’t for the better. But, none more so than national governance.

Possibly the most unacceptable “change” politically has been those in office – especially federal – becoming a self-perpetuating ruling class rather than representatives of the people. Somewhere along the line, our issues became less important than their fanatical desire to stay in place. Too many officeholders look upon the electorate as a means to their own ends rather than acting as people we’ve chosen to temporarily deal with our national needs.

“Town Hall” sessions and other constituent events are, in the eyes of many pols, things to be avoided. No phone calls. No meet-and-greets. No direct contact if it can be eliminated. Idaho, especially, has a couple of Senators for whom those are the rules, not the exceptions.

In my life, I’ve met too many politicians who’ve said, “If you knew what I know, you’d agree with me,” Time and time and time again. Too damned many. We’ve lost the ability to have our legislative desires dealt with. We’re often treated as subjects rather than citizens.

And, of course, the Internet, fraught with change. Some good: access, education, communication, medical, et al. Some bad: communication. While the I-net has enhanced nearly every aspect of our lives, it has also exhibited and communicated hate, bigotry, danger and outright criminal behavior for millions. While most of us have learned to use it as an ever-changing tool for good, it’s also had a concomitant effect for criminal and immoral activity.

Sometimes, it’s the resistance to change that’s more troubling. Idaho, for example, has a vocal group of “anti-changers” vowing to cut the operating budget of Boise State University for instituting gender-neutral restrooms on campus. Loudest voice is a “legislator” from Eastern Idaho who was thrown out of a Boise restaurant for carrying a rifle with him at lunch. Methinks payback is more on his little mind than who uses what bathrooms at BSU 250 miles from his home.

That old saw “change is constant” is as apt today as it was when the first Neanderthal muttered it. While there are many examples of change not necessarily for our betterment, it’s safe to say most has been beneficial. The continuing evolution of change is, actually, about the most constant thing in our lives these days. There’s really not much we can do about it except to take the “hits” and keep on going. Resistance – even in bathrooms – is futile.

You might have noticed I haven’t included our miscreant liar of a President in these musings about change. Deliberate, I assure you. After all, not all change has to be permanent. And he’s the textbook case for the necessity of c-h-a-n-g-e.

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This impeachment business has become an overwhelming saga. It’s taken all the air out of the room. Not that it isn’t warranted. It is. And will continue so for several months.

Trying to keep up with daily disclosures and the changing cast of characters is quite a job for political junkies. As the old movie posters used to say “cast of thousands.” Though I’ve kept pretty current, I’m still trying to wrap my head around two pieces of the saga. Just two.

First, why, according to polls, do some 30-million Americans continue to support Trump? Given the list of outright legal and moral atrocities he’s committed – both in office and before – why does polling still show a solid block of nearly a third of voters from the 2016 election still waving their MAGA hats?

In fact, a reliable national poll a few days ago showed 52-percent queried would still vote for him “NO MATTER WHAT HE DOES!” Fifty-two percent!!! And that wasn’t just Republicans.

As a secondary issue under that same query is yet another of even more curiosity. Given his repeated marital infidelities, payment of bribes to buy the silence of a couple dozen women, his continual lying, outrageous flaunting of “family values,” defying the constitutional requirements of his office and all his other political and moral felonies, why do the Evangelicals still back him to the hilt? Why do they – by the millions – loudly professing their adherence to a godly life and the holy teachings of Jesus Christ, stand so solidly behind him? How do they square that with their own moral beliefs?

The second confounding issue is strictly political. In last week’s vote to proceed with impeachment in the House, why did 192 Republicans – every single one – vote against the resolution laying out that process? Though some may not have meant their vote as meaningful support for Trump, there really is no other viable political reason given the public evidence so far. I’d bet a few swallowed hard. Real hard.

I know. I know. They’re bitching about the “process.” Absolutely bogus. If there’s any certainty in this whole mess it’s that Speaker Pelosi and her crew will take every precaution and run that process strictly “by-the-book.” They’ll make absolutely sure the bill of impeachment that goes to the Senate has every “I” dotted and every “T” crossed. You can bet the farm.

The reason for my consternation about last week’s vote is this. Trump has turned against dozens of people in his administration. He’s fired – or otherwise forced to quit – cabinet members, chiefs of staff, lawyers and assorted flunkies. And he’s publically vilified other staffers who – for reasons unknown – took the undeserved beatings and stayed on the job. He’s betrayed so many people he can’t find highly qualified candidates for all the openings available.

Congressional Republicans, we’re told, say in private they fear Trump will put up someone to run against them in the next GOP primaries. He’ll try to get revenge. Road apples! If some nutcase in your own primary scares you, that’s hardly sufficient cause to turn your back on the oath you swore to “uphold the Constitution against all enemies, foreign and domestic.”

Somehow, getting into – and staying in – Congress has become more of an employment issue than a desire to undertake public service for its own sake. We’re seeing proof of that in so many ways as members of Congress bend this way and that to stay ahead of the political winds. Last week’s vote was just the most recent example.

Sooner or later, Trump will turn on any one of them. Bet on it. For example, any day now, watch Giuliani disappear under the bus. And those two Ukranian criminals? If we can keep ‘em in the country long enough for a trial, they’ll have Trump tire marks right up their backs.

Trump’s most certain trait is self-preservation. In his mind, he’ll survive even if everything goes to hell. Look at what he’s doing now. Handing out thousands of dollars to Republican senators running for re-election. Put another way, imagine the criminal on trial in your hometown, standing on the count house steps, handing out big bucks to the jurors as they file past. That’s exactly what he’s doing. Bribing the jury. Nothing more than base self-preservation.

Many Republicans standing with Trump today will be tomorrow’s bodies on the political landscape.

Evangelicals by the millions, accepting the moral degradation of someone who violates all they espouse in their own morality and Republican members of Congress who’re selling their self-respect at the foot of a false political prophet.

However this impeachment story turns out, I’ll never understand either.

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