I'm living a sort of good-news-bad-news joke today.The bad news is that the business picture for my business hasn't gotten any better so, as advertised, my employer has cut the staff hours down to 24 per week.Working - or not working - a three-day week pretty much sucks. Getting by on 60% of your normal income isn't a good thing, either. But there's not much I can do about it at the moment, anyway, except try and look at the good-news aspect, which is that if I am going to have to take a day off without pay, today was a good day for it. The weather is gorgeous and my little boy's "Field Day" was today, so I got to go over and play with him and his little kindergarten classmates as they raced and jumped and wriggled and were otherwise as energetic and adorable as a clowder of kittens.After Field Day I went and had a delicious leisurely lunch at the Little Red Bike Cafe, absolutely a Cool Thing in North Portland, and spent the next several hours doing household chores, making phone calls to try and reduce our spending on things like insurance, cable TV and the Internet, and re-reading Diane Gabaldon's entertaining "Outlander", as much fun now as it was when I first read it several years ago. Watched part of a truly bizarre Johnny Weismuller "Jungle Jim" movie on TCM and taped the UEFA Champions League Final - I haven't watched it in hopes of luring Brent and his current inamorata Heidi over to see it this weekend, but...go, Barca!And then sat down to post this.At some point today a friend from this blog, Charles Gittings, is going to try and drop in. He's passing through between Seattle and California, where he's getting some medical work done, and his situation got me thinking of medicine, health care and the contretemps surrounding "health care reform".I think, and have thought for some time, that the way we distribute and pay for our medicine in this country is beyond flawed. It is, quite literally, insane. The notion that sickness and injury need to somehow become profit for everyone involved except the sick or injured person, from the insurers to the doctors to the hospitals, clinics, laboratories and hospices...that's lunacy. It's like making war for profit, or making love for profit. The incentives for misbehavior are legion, and the restraints on any sort of mischief, well...Atul Gawande has a good piece up at the New Yorker that looks at this as exemplified by the little town of MacAllen, Texas. It's not pretty, and it should make you think.
The bottom line is that sick people or injured people are going to need care. And only the most over-rich communities can afford such care without some limits on the amount and the cost. So in some way that care will be rationed. At the moment we have chosen to ration care by income. If you are wealthy, you can afford care without limit. Make a living wage and hold down a decent job - and remain relatively healthy - and you can still afford a lavish regime of treatmeent for your ailments.
Become old, or sick, or unemployed...well, one hopes that Illness will be merciful and Death will be kind.That seems fundamentally unjust. Does the elderly woman dying in her broken bed in her unheated shack love her life less than the elderly woman in her soft sheets and elegant bedroom? We seem to believe so, for we have set up a system that punishes the poor and rewards the wealthy. One suspects that this is a reflection of our political system, which empowers the powerful and disenfranchises the powerless.I wish I saw a change in the future. I do not. The forces arracyed against such a change are simply too strong.Oh, and the pictures are all from the Astor School 2009 Field Day. Go, kindergartners!