PSA

One of my jobs is English-to-English translation, as people always seem to have trouble understanding each other.

While I am home recuperating from surgery, I thought I’d explain a few medical terms for your edification.

Public Service Announcement

  • “Minor surgery” – anything done to someone else.
  • “Procedure” – surgery that your insurance won’t fully cover.
  • “Outpatient procedure” – surgery that even Medicare won’t fully cover.
  • “This won’t hurt a bit” – It won’t hurt me to do it to you. I can’t say what it will feel like on the receiving end.
  • “Just a little prick. It’s not really painful.” – The President is just a little prick, too; but he causes plenty of pain.
  • “This may cause a little discomfort.” – Yeah, doc, let me do it to you and then tell me about discomfort.
  • “Deductible” – Don’t even think about using your insurance before you’re broke.
  • “Co-pay” – You think you’re insured, but we think that unless you have a little skin in the game, you’ll actually try to use your insurance. This’ll make you think twice.
  • “Co-insurance” – Ha! After you satisfied the deductible and made the co-pay, you thought insurance would cover the rest – sucker! Now you get to split the rest of the cost with us!
  • “We’ll just run a few tests.” – We bought this new (and really expensive) machine. The only way we can afford it is to use it a lot and bill you for it.
  • Bonus! Want to save on medical expenses? The TSA scanners have an uncanny ability to detect injuries! My most recent scan found a cavity before I went to the dentist. That’s not to mention the other injuries they have found.

Worker’s Compensation

The popular myth about Worker’s Compensation Insurance is that it is there to protect workers from unsafe working conditions. As Paul Harvey would say, here’s the rest of the story: Worker’s Compensation Insurance is (also) there to protect employers from lawsuits by employees. If you are hurt on the job, you can’t sue your employer for damages. You can file an insurance claim and hope the insurance company (which works for the employer, not you) will agree that your injury was caused by your job and pay for your medical care and a portion of your wages while you are unable to work. More likely is that they will dispute your claim, asserting that you had a pre-existing condition or that your injury was caused by something you do in your spare time. To collect the benefits you are owed you may have to hire an attorney to represent you even though you can’t sue.

Another popular myth is that workers fake injuries in order to collect benefits. Since benefits are set at a fraction of your wages, you have to be pretty stupid to get only a portion of your wages (unless you have some other lucrative job you can perform while collecting benefits, a rarity indeed) while living on savings or scrimping to get by. The insurance company may spend more on surveillance (hiring private investigators to follow you around and film your activities) than the cost of compensation for the injury. An article in the Journal of Social Research (Tennyson, 2008) asserts that industry estimates of fraud are grossly exaggerated (by a factor of 10) and that surveillance activities decrease trust and lead to increased fraud.

In The American Journal of Industrial Medicine, Spieler and Burton (2012) cite more than a dozen reasons for under-reporting of work-related injuries and illnesses and cite conclusions from other studies including ” at least 80% of all medical costs caused by occupational diseases were missed by workers’ compensation programs.” (Leigh and Robbins, 2004)

So are workers ripping off the system in large numbers, as popularly believed? Or is the system ripping off workers in large numbers, as the evidence suggests? The evidence suggests that workers fail to report work-related injuries for multiple reasons including fear of retaliation, and that insurance companies fail to pay for work-related injuries for multiple reasons including asserting that doctors can’t prove that the job was the sole cause of the injury or illness. The evidence also suggests that insurers will go to great lengths to discourage claims and to reject those that are filed.

What do others think of US Healthcare?

Most of the world has a healthcare system. The US has an insurance system. Why does it not strike us as odd that we have a “system” centered around an industry that makes its money by withholding care? The more premiums we pay and the fewer services they pay for, the “healthier” the system is. Take a few minutes to watch the video above and hear what people who have a healthcare system say when asked what they think about the cost of care in the US. Our leaders and our media want to convince us that we can’t afford a single-payer system. The rest of the world recognizes that we can’t afford not to have one.

Human Resources

Resources have value based on the cost of extracting them versus the value added to the product. A few years ago, when the fracking boom hit, western Wisconsin was found to have the best frac sand around. A new industry appeared. They blew up fields to mine sand and built new railroad lines to haul the sand to natural gas wells. A few years went by, and they decided sand in Texas was cheaper, closer to the gas deposits, and good enough. The Wisconsin sand mining industry went bust.

If you are a highly skilled widget maker with 20 years of experience and know things, like where to bang on a machine to restart it when it freezes up, and you make great widgets, and you pay attention so that you know stuff that no one else in the company knows, you get paid well. But maybe they do some calculating and decide that a newly-trained widget maker, who gets paid a lot less, will do most of the time. When the machine goes down or they don’t know where to find something, maybe they figure the lost time will be made up for by the lower wages. Now it’s time to get rid of you. Having Security walk you out of the plant may be bad for morale. What to do, what to do?

Maybe they can make it unpleasant enough that you’ll take early retirement to avoid the headaches. What if they suddenly start making mistakes on your payroll? Or maybe change your family health insurance plan to a single plan without telling you? Maybe your pension contributions get messed up. Maybe, if you notice the mistakes and complain, they’ll get fixed eventually. Or maybe you’ll just get fed up and leave, allowing then to bring in a lower-paid worker. Nah, that would never happen, right? But if the cost of extracting your value becomes greater than the value added to the widgets, start watching those paystubs carefully.

Weather and Climate

We’ve talked about weather and climate before. We’ve linked to data on the freeze/thaw cycles of one Wisconsin lake that has been studied for more than 150 years. While this year’s weather should not be mistaken for climate, in October we were ice fishing. In January we could be swimming, though it would be a bit chilly. October’s ice is gone. The lake is liquid again and the temperature is pushing 50. Since 1852, this lake has melted and re-frozen in the same season six times. Five of those have occurred since 1977.

The preview is old. Don’t try to tune in on the date mentioned.

In case you’ve been wondering where we’ve been, we’re around – we just had nothing to say for a while. Now we can’t ride a bike for a while, so…here we are! Comments welcome. Watching TV is going to get old fast, so let’s talk.

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Photo credit: John Hart, Wisconsin State Journal 01/07/2020

More kids growing up

I went on a long ride Sunday – long mostly because of the 20+ mph headwind for the first 35 miles. I got home in time to see Joel Paterson and the Modern Sounds at the Pursuit of Joel PHappiness Festival. Joel is a phenomenal guitarist who can play anything. He has a number of bands to give him a chance to play multiple styles. The Modern Sounds play old jazz and swing with a little rockabilly, R&B, and blues in the mix. He started playing in these parts as a kid, then grew up and moved to Chicago. He also figures into my life in an indirect sort of way.

Those who know me in another part of my life know I work in health care. It was Joel’s mom who started me on that path. When I was 20 I injured my ankle. I was treated in an emergency room (after fashioning a crutch to get back down from the mountains, but that’s another story) while traveling but it didn’t get better. Walking was an interesting adventure. Running was out of the question. I went to my local free clinic (The Near East Side Community Health Center, which has merged into Access Community Health Centers, run by my friend Ken Loving – another story for another time).

In the free clinic, there was a volunteer position called “Patient Advocate”. The Advocate’s job was to act as a medical assistant (gathering health history and chief complaint) and more. It was the advocate’s job to be sure the patient’s needs were met. The advocate helped the patient formulate questions for the doctor, guided them with follow up questions as needed, and ensured that their needs were met before the doctor left the room.

Joel’s mom was my advocate. (She had also been my sister’s high school classmate.) Before I left the clinic that night, she extracted a promise that I would return as a patient advocate after I saw the orthopedic surgeon they referred me to.

I went back and volunteered as an advocate for a few years. Something must have stuck with me, as I became an Occupational Therapist about 25 years later. Patient advocacy is still an important part of my job.

Joel has a YouTube channel that can give you an idea of his range. Or you can look at what others have uploaded here. I’m not sure what to pick to just link to one or two things. Here’s a Scotty Moore tribute:

Here’s a bit of swing:

How about blues?

Now go listen to him live and buy his albums. A musician can’t make a living if all we do is watch his/her YouTube videos.

Back to bikes for a minute. A while back I posted a series on bike safety. I thought I was done but I left something out – and it’s something I’ve used the past few days.

It’s a baseball metaphor. For those of you who have played, you know what it means to “look the runner back”. You can skip the next paragraph. For those who don’t, read on.

If you’re playing shortstop and there’s a runner on second and a ground ball is hit to you, your natural play is to throw the batter out at first; but you don’t want the runner on second to go to third. You “look him/her back”. You make eye contact in a way that says, “If you break for third, you’re out. Better stay where you are.” When the runner turns back to second, you make your play at first.

It works with drivers. You’re at a four way stop. The car to your left was there first and has the right of way. You let her/him go. The car behind her/him decides to go at the same time. You look her/him back; making eye contact in a way that says, “wait your turn.” That driver know it’s your turn to go and was hoping you’d be cowed because their car is bigger than your bike. Most of the time, the driver will acquiesce, knowing they were trying to pull a fast one. If they go anyway, you let them. You both know what’s what.

In this way you can be an assertive, not aggressive, bicyclist.