Secret GOP Healthcare Plan Revealed

The Bartender is In

If you are wondering what might be in the super-secret Senate bill on revamping the nation’s healthcare system–wonder no more. For I am about to reveal the details based upon some recent personal input on the matter.

Knowing full well that the Senate would be tasked with coming up with something a bit less mean than what the House presented to the President, and also being aware of the fact that the Senate can be just as mean and nasty as the House, I took it upon myself to formulate my own blueprint for the overhaul of healthcare.

Now one might be tempted to question my credentials on the issue. But as a working bartender of almost 45 years, I have been at the forefront of practical medicine for most of my life. And I am certainly no less qualified than the majority of those senators and congressman that will ultimately decide the issue.

The following letter was emailed to the offices of key members of the United States Senate, including all those that currently sit on the Healthcare Committee:

To the Honorable and Reasonable Men and Women of the United States Senate:

While I do not have any accredited expertise on the issue of providing healthcare coverage to the citizens of this country, with each passing day it becomes increasingly self-evident that the democratic process allows even the least qualified among us to lay claim to having all the answers. So as someone who has at least served as an elected official in municipal government and has had the benefit or curse of having worn numerous professional hats along with a number of inconsequential caps over the course of 63 years, please bear with me as I toss my somewhat shopworn chapeau into the ring.

First off, it appears that both the previous and current administration, either by design or default, became mostly fixated on how to placate and finance the insurance industry. In spite of the fact that most Americans would probably place the blame for their premium woes on the perceived greed of the insurers, and while certain aspects of the customer service practices of these providers might help to fuel those perceptions—most of these companies operate at or below the average profit margins of the majority of all U.S. businesses. While there are probably some legislative actions, such as tort reform and creating larger insurance pools, which could lower premiums to some degree, the real savings is in addressing healthcare practices and the delivery of services. The question then becomes how do we rein in the costs of that which represents nearly 20 percent of the nation’s GDP without harming the overall health of the economy? And what should be the role of government in that process?

There are those that propose single payer universal healthcare, and there are those that would prefer a totally market-based solution. Without giving away my own personal preference, let me just say that neither approach is realistic under the current political climate. So as usual, it will require creativity, compromise, and consideration from both camps to bring about any meaningful change. So for what it’s worth, here are a number of ideas and observations to ponder.

1.) During the last few decades our country has experienced a rather baffling rise in both the cost of healthcare and higher education. I say baffling because neither situation has produced the improved outcomes that one might expect when measured against the cost. And when you factor in the information technologies available to both professions, the qualified practitioners of both medicine and learning should in fact be providing a much better product at a more equitable price.

I am not suggesting that those dedicated men and women on the front lines of either healthcare or education be paid less for their services, but I suspect there are a great deal of savings that lie just beyond the doors of the classroom and the operating room. And while the factors that drive costs in either institution do not necessarily make the case for a valid comparison—one only needs to take a stroll on the lush grounds of an Ivy League university or walk down the corridors of a sprawling hospital complex to know that both healing and enlightenment could be achieved in much more affordable surroundings. The question is, who will take the lead in the creation and construction of those surroundings—the government or the free market?

2.) In order for actual market based competition to occur within the healthcare industry, I believe two things must be addressed: the lack of transparency when it comes to actual costs, and the other being what I like to call “Car Wash Medicine.”

As to the latter, the recouping of one’s investment and eventual profitability in an automated car wash is dependent upon a never ending stream of dirty cars passing through the machine. Thankfully, the owners of these car washes can depend upon the vagaries of Mother Nature and the capricious hygiene habits of our winged friends to guarantee a healthy supply of customers. But this is not necessarily true in the business of healthcare. While all of us will eventually become sick or sustain injury, and perhaps even come to harm as the result of some chance encounter with a bird, the successful treatment of those maladies is not always dependent upon being subjected to the expensive technologies afforded to us by modern medicine. And yet it seems that no treatment regimen is complete without first being screened and scanned. I guess the medical community can’t afford to let that expensive CT or MRI machine sit idle for too long.

As to the matter of transparency, most of my time alive has been spent living in New Jersey. And while I can’t speak about oversight in the other 49 states, if the Garden State is a typical example of how healthcare providers operate throughout the country, then one must come to the conclusion that in fact there is no true market based competition going on. Depending upon the location, the same identical routine tests and procedures can vary in cost by thousands of dollars. And since those costs are most often negotiated under the cover of nondisclosure, the average consumer, who normally finds his way into the system by way of an ambulance with very little choice as to where to go, becomes doubly victimized by the unethical price fixing and price gouging that is being done all in the name of medicine.

3.) The repeal of the Affordable Care Act will most likely lead to another spike in the number of uninsured people seeking expensive emergency room treatment. Those who cannot afford insurance or preemptive medical care are left with little choice other than to wait for a symptom to become a sickness.

By developing an extensive national network of free or low cost government supported community clinics for poor and low income Americans, we could greatly reduce the number of emergency cases that have brought many of our hospitals to the brink of financial ruin. And as an incentive to attract qualified personnel to staff these clinics, the government could offer to pay for the cost of nursing or medical school in exchange for two years of service in those areas of the country that are underserved by the medical community. Considering the fact that the average new doctor finds him or herself with nearly two-hundred thousand dollars of student debt before they even see their first patient, I believe many of these newly trained professionals would gladly be willing to work for a bit less money at the beginning of their careers.

4.) We could be just one breakthrough away from freeing up $175 billion a year of government monies. Currently, approximately 18 percent of the annual Medicare and Medicaid budget is spent caring for people afflicted with Alzheimer’s and other forms of dementia. By 2025, that cost of care is estimated to reach $237 billion. While the Congress has already committed a substantial increase in research funding for this year’s budget, it is incumbent upon all of our elected representatives in both the House and Senate to guarantee that we will continue to aggressively fund those public and private entities that are engaged in the search for a cure. Other than the ravages  of cancer, no other present medical condition has brought greater sadness or suffering to humanity than Alzheimer’s disease.

5.) Finally, it is safe to say that there will be an enormous amount of push back from those who might be adversely impacted by any attempt to control and cut the cost of healthcare. And certainly an industry that makes up such a large portion of our economy will strongly plead the case for maintaining the status quo when it comes to protecting the current model of medical care in the United States. But for the sake and wellbeing of those who represent the other 80 plus percent of our gross domestic product, now is the time for our leaders and legislators to exhibit a little more conviction and whole lot more courage!

Furthermore, as we begin the process of considering cutting taxes on both businesses and individuals in order to spur growth, we should not lose sight of the powerful boost to the American economy that would come about simply by reducing the undue financial burden of runaway healthcare costs. American companies would become more profitable, government would see increased tax revenue—but most importantly, our citizens would be less stressed, more secure, and a lot healthier. Because nothing promotes the general welfare of the people better than knowing that they will have the means to enjoy the rewards of life–and the resources to cover the cost!

Thank you for your time and attention.
Christopher M. Poh

Of course there is that distinct possibility that in the process of amending and reconciliation that my recommendations will not be fully incorporated into the final bill. In the event of that outcome, I will prescribe the following in lieu of genuine reform and repair of our healthcare system:

  • Get plenty of exercise. Lifting full pints of  ale is a good start. Dancing on the bar is aerobic, but not recommended for older patrons.
  • Socialize more. Take your eyes off the damn TV screen and engage in some constructive communication with the person next to you.
  • Finally, take two aperitifs and call me in the morning–but, please, not too early!

Click glass Bluecoat Gin Martini for additional treatment options.

Posted by: Chris Poh for American Public House Review

Another Bah Humbug on Bleecker Street

Scrooge and Bob Cratchit sharing a Smoking Bishop

“A merry Christmas, Bob!” said Scrooge, with an earnestness that could not be mistaken, as he clapped him on the back. “A merrier Christmas, Bob, my good fellow, than I have given you, for many a year! I’ll raise your salary, and endeavour to assist your struggling family, and we will discuss your affairs this very afternoon, over a Christmas bowl of smoking bishop, Bob!”          

– Charles Dickens, A Christmas Carol (1843

Though our journeys together over the last twelve months have been to some extent curtailed because of our individual circumstances, me and my cohorts at American Public House Review  were at least able to once more gather together at year’s end to celebrate the season with yet another attempt at properly paying homage to Mr. Charles Dickens. The following version of A Christmas Carol was recorded during The Bleecker Street Cafe in the broadcast studios of WDVR-FM in Sergeantsville, New Jersey on December 20, 2013. It is with great pleasure that we share this year’s somewhat faithful adaptation of Mr. Dickens’ finest work.

So stoke the fire, stir the Smoking Bishop, and sit back and enjoy by clicking on the following links:

christmas_carol_logoA Christmas Carol – part one

A Christmas Carol – part two 

Here’s Wishing Everyone  a Very Merry Christmas!

By George…the Boys from Finger Lakes Distilling Have Done it Again!


Finger Lakes Distilling - Lake Seneca, New York

“Two hundred gallons of Whiskey will be ready this day for your call, and the sooner it is taken the better, as the demand for this article (in these parts) is brisk.”

Letter from George Washington to his nephew, Col. William A. Washington, 1799

I am just about to crack open my last bottle of the McKenzie Rye Whiskey from Finger Lakes Distilling, so that I might have the proper libation while reading about the lad’s latest adventures.  It seems that Brian and Thomas Earl McKenzie recently returned from a week of working their copper pot magic at George Washington’s reconstructed distillery at Mt. Vernon. They were there as part of a team of handpicked  American craft distillers tasked with the recreation of  our first President’s peach brandy. Click here for that grand tale.

Brian and Thomas Earl McKenzie at Mt. VernonWhile Washington’s main focus was the production of  rye whiskey, he did develop a taste for the fruit brandies early on–and I am proud to say that it was a Scotsman from my home state  that introduced the good General to the virtues of this particular nectar.Robert Laird served with the Continental forces under Washington, and it was  his family that  supplied  the troops with Apple Jack from their distillery in Scobeyville, New Jersey. 

 The McKenzie RyeUnfortunately for me, while I can get plenty of Apple Jack here in New Jersey, the McKenzie Rye is not yet available for distribution in the Garden State, and the word from the distillery is that their cupboards are bare until early 2011. Even If I were to employ the standard Continental Army ration of  1 gill per man, and then limit my consumption to only every other weekend, I would still deplete the McKenzie before Christmas.  

I guess I better find my  recipe for the  Jack Rose cocktail.

Posted by: Chris Poh

One For My Baby…

Bull Shot - P. J. Clarke's

Bull Shot – P. J. Clarke’s

There are just too many days as of  late when I find myself feeling a level of post meridiem melancholy that would normally be  reserved for those wee small hours after midnight. But this extended period of  pensiveness does justify my singing the first few lines of that Mercer/Arlen classic at least twice a day now.

One For My Baby (And One More For The Road)

It’s quarter to three,
There’s no one in the place except you and me
So set ’em up Joe
I got a little story I think you ought to know

We’re drinking my friend
to the end of a brief episode
So make it one for my baby
And one more for the road…

The talk around Tin Pan Alley was that Johnny Mercer worked out the lyrics to Harold Arlen’s unconventional 48 bar,  key changing melody while sitting at the bar at New York’s P. J. Clarke’s. Another famous patron would  fan the flame of this American torch standard with a version that would ultimately define tears in your beer and late night laments. And this is only fitting, since Frank Sinatra, who is more often associated with Sardi’s and Jilly’s when it comes to prominent city saloons, would always raise his last glass of the evening at P. J. Clarke’s when  socializing in Manhattan.

In the current issue of American Public House Review there is an effective recipe for a Bull Shot which this editor first discovered while sitting at the aforementioned landmark tavern on a similarly cold gray afternoon  many years ago. It occurs to me that there is just enough vodka left to make two.

So I think I’ll throw on a little Sinatra, and have one for my baby… and one more for the road. (Click the last two links to hear Francis Albert Sinatra do it as only he can)

Posted by: Chris Poh


The High Ball – Remembrance of a cocktail

highball-002-de11My parents entertained frequently as I was growing up in the 60’s. On many a Saturday night, I was put to bed early while my father and mother hosted festive soirées for the gang from The Presentation BVM Parish Society.  These were not the composed and level-headed “cake and coffee” socials of friends well met through their church congregation.  No, these were Roman Catholics who appreciated gospel stories where the operative metaphor was the miraculous transformation of water into wine. These Faithful accepted as Divine Revelation that Jesus himself enjoyed a party, savored the spirit of the grape, and even knew, but did not always hold to, the etiquette of when, during a celebration, to serve the finest vintage. In other words, The Presentation BVM Parish Society partied at my parents’ humble home in Northeast Philadelphia with a generous flow of love in their hearts and the holy distillation of God’s own harvest in their cocktail glasses. For a while, as any kid would, I fussed about my banishment from the living room and our lone TV. But, I soon discovered that from my stealthy, spy perch at the top of the steps I could secretly bask in the adult exultation downstairs. I also learned that the most popular drink by far which was raised in the countless toasts proposed was the Highball .  .  .  at least it was at my parents’ Kennedy-era galas.

A recipe is available for this cocktail which is simple, but not without requisites. Please click:

The High Ball

Posted by: Ed Petersen

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