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.
Sincerely,
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

Closed for Repair (Take Two)

 

Closing Time at the Indian Rock InnIt was brought to my attention by a number of readers of the last post that something might have gone terribly awry with my attempt at condensing my thoughts into a bit of poetry. I want to assure those kind folks that I was not in anyway trying to emulate the unconventional style of E.E. Cummings, nor had any of my own fragmented behaviors and tendencies now become manifest in my writings. Apparently the problem was a matter of browser perspective. In my world of Google Chrome, everything appeared as it was meant to be. But for those using other browsers and smart phones that may have not been the case. So hopefully, this change from straight text to an image file will assure everyone that I am only mildly disjointed in my thinking.

Closed for Repair

Closed for Repair_3j

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Published in: on July 3, 2014 at 5:09 pm  Comments (1)  
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Terms of Engagement

Cowboys at the Rusty Spur in Scottsdale, AZ

Over the past few weeks, I’ve been spending a bit of time with the latest book to make it to the top of my perpetual must read pile before my somewhat languid brain loses its ability to even process the written word. In this particular instance, I’ve actually given an author’s efforts something of an in-depth dabble as opposed to my usual cursory perusal. Certainly this amounts to the highest of praise for John Fabian Witt’s Lincoln’s Code. This excellent narrative examines America’s role in defining the rules of government sanctioned armed conflict, with an emphasis on Abraham Lincoln’s input on the matter of trying to bring  fair play, dignity, and perchance even a touch of charity to the bloodied fields of combat. While I do not discount the sincere intent of those who throughout history have endeavored to bring a modicum of humanity to the battlefield, there is that ever skeptical side of me that questions their underlying motives–whether it be the likes of Lincoln, Jefferson, Washington or any other supposedly enlightened and regarded individual. 

I’ve always suspected that the call for order and civility in the midst of organized carnage is as much about justice as it is about those that started the fight trying to avoid retribution and the hangman’s noose when the fog of war finally lifts. And then of course there is the political practicality of having something left above ground to exploit and govern after the fallen have been properly placed below ground. Perhaps the only thing that might appear to be somewhat more disingenuous or hypocritical than our attempts to codify the institution of war is our attempts to codify the institution of marriage. But at some point during the current session of the Supreme Court, those erudite legal minds seated in chambers across the street from the U.S. Capitol will consider doing just that.

While I understand the level of discomfort expressed by those who argue against gay marriage on moral and religious grounds, I have come to my own conclusions based on personal experience. During my time behind the bar, I have established close friendships with a number of long-term committed gay couples. In all instances, these loving people have fostered  positive changes in environments that normally would have been less than accepting of any homosexual individual prior to them quietly working their way toward establishing regular’s status. In fact, their  presence helped to bring about a greater degree of acceptance, patience, tolerance and kindness toward all clientele, no matter what their gender, political persuasion or sexual orientation might be.

In the text of his Second inaugural Address, Lincoln reminded us to act in accordance with the words of Matthew 7:1, “let us judge not that we be not judged.” It is time to award all who choose the bonds of steadfast love an equal place at the bar–in hopes that we all may be granted an equal place at that eternal table.

Posted by: Chris Poh

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Our Condolences to the People of Boston

As seen in American Public House Review

As the situation in Boston continues to unfold, the editors and contributors of American Public House Review and Parting Glass Media extend our condolences, well wishes and prayers to the citizens and first responders of this great American City.

Published in: Uncategorized on April 19, 2013 at 9:55 am  Comments (2)  
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Another Flock in Search of a Good Shepherd

Sculpture of St, Francis at Pacem in Terris - Photo by Luz Piedad Lopez

Sculpture of St. Francis at Pacem in Terris – Photo by Luz Piedad Lopez

If you want to get to heaven
Over on the other shore
Stay out of the way of the blood-stained bandit
Oh good shepherd
Feed my sheep… From the song “Good shepherd” by Jorma Kaukonen (Jefferson Airplane) 

As the world awaits that rising plume of white smoke signaling the selection of a new pontiff, one might wonder why a species so dominated by secularism is still so enthralled by the somewhat byzantine rituals and vagaries of the Vatican. By now you would think that we would not be looking to an institution so rife with scandal and controversy to reset the moral compass. And yet there is that aspect of the human spirit that causes us to hope that those foundational organizations that are central to the well-being of society, whether they be governmental, educational or religious, will at some point rise above those inherent corrupting forces that challenge all of mankind.

As to my own personal search for the “good shepherd”, I chose a path that would not lead to Rome, but instead  to the small village of Warwick, New York. My place of spiritual reflection would not be a  marble covered cathedral, but rather the restored ruins of an old stone mill. It was here that the late author, painter, and sculptor Frederick Franck would construct and create Pacem in Terris–a trans-religious retreat and sculpture garden honoring  the work and humanity of both Albert Schweitzer and Pope John the XXIII. Although himself an  agnostic, Franck had developed an affinity and a deep respect for the Pope while sketching the sessions of the Second Vatican Council.

Just two months before his death from cancer, on April 11, 1963 , John the XXIII issued his final papal encyclical Pacem in Terris (Peace on Earth).  The same man who had saved so many Jewish lives during the Holocaust while serving as the Apostolic Nuncio to France during the Second World War, and who as Pope had worked tirelessly to bridge the divide between the faiths, would now call upon his fellow Catholics and all of human kind to strive to achieve global peace, economic security, and international justice. In the midst of the nuclear arms race, Communist aggression, racial inequality, and worldwide poverty a truly good shepherd had come to pass–giving us some  reason for hope concerning the outcome of the current conclave.

It was during some of my more contemplative wanderings and moments of meditative seclusion at Pacem in Terris that I would  find myself leaning toward the notion that there are those among us who might just have a more direct line of communication with the divine.  But then my own personal struggle between the secular and the sacred would take hold, and I would find my doubting self in need of some additional solace and inspiration. Thankfully, the village of Warwick is also home to Yesterdays Restaurant and Pub–the perfect place to renew ones spirit while partaking of the holy water.

Yesterdays Restaurant and Pub - Warwick, New York

Yesterdays Restaurant and Pub – Warwick, New York

Posted by: Chris Poh

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We the Fearful People

S&W 357 Magnum

A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.

In the last few days, I’ve allowed myself to become a party to no less than three heated bar stool discussions concerning the current national debate over the Second Amendment, and the potential impact by way of regulatory legislation on our rather well-armed citizenry–I myself being among our gun-toting populace. As usual those on both sides of the argument are armed with their  statistics, perceived truths and enough claims to the moral high ground that it might appear to the average detached  American that both sides are right. And to some degree both sides are in fact justified in wanting to cling to their much cherished positions on the matter. Because the national discourse of the moment reflects some of the very concerns expressed by the framers of  The Bill of Rights in 1789.

Concerning the Second Amendment, there were those founders who felt that the only way to insure the future freedom and security of the new nation against the possible tyranny of government, be it foreign or domestic, was to make sure that a citizen’s right to own and carry arms was  enshrined in the Constitution. But there were also those equally wise and well-educated men of the time that were fearful of the potential mayhem, mob rule and anarchy posed by arming a civilian population. So like those much revered fellows of the eighteenth century, we find ourselves once again bringing our own exaggerated personal fears in regard to the proper and legal role of the gun in American life.

There are those who live in  fear of  that armed threat lurking in the shadows that wants to take away their lives. And there are those that live in fear of that threat lurking in the legislature that wants to take away their arms. But for better or for worse, we have as much of a right to our fears, no matter how unfounded, as we have to our rights concerning firearms and freedom of speech. So perhaps we would be better off  if both the gun advocates and the gun control people admitted that their passions are more likely fueled by fear than by actual facts. And at this particular juncture in our nation’s history we might consider a respectful dialogue in lieu of demonizing those with an opposing  point of view. 

My own personal instincts on the issue tend to put me in league with those that believe that additional laws banning the use of certain types of weapons will do little to stop the type of carnage recently experienced in Newtown, Connecticut. On August 1, 1966, Charles Whitman killed 14 people and wounded 32 others at the University of Texas in Austin, using only a shotgun, an M1 carbine and a couple of standard hunting rifles. On the other hand though, if some of the measures being suggested today, such as using mental health records as part of an overall background check were in effect at the time, that tragic event may have been avoided. Charles Whitman purchased weapons at two separate locations on the day of the shootings. Months earlier he had sought out both medical and psychiatric help, expressing concerns about trying to cope with the suppression of his extreme violent impulses.  

Lastly, the term well regulated was apparently key in the penning of the Second Amendment. And even though the case can be made that rules and regulations don’t necessarily change behavior,  it is those decrees coupled to the force of law that says who we are as a society. We the people might want to consider foregoing a few of our own fears in the interest of domestic tranquility, and the possibility of actually achieving that more perfect union.

Posted by: Chris Poh

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The View on the Way Down Might Not Be Half Bad

Killarney ParkWhile I can be potentially as pessimistic as any American about the ability of our elected officials to shepherd us through these difficult and dangerous times, on this rare occasion, I applaud the combined  political aplomb of both Democrats and Republicans. By keeping a crisis weary nation focused on the possibility of going over the so-called fiscal cliff on January 1st, they have effectively shifted our attention away from the pending December 21st end of the world supposedly prophesied by the Maya. This clever bipartisan manuever will ensure that Americans will press on with their holiday plans, thus insuring a robust fourth quarter in consumer spending. Now as to whether or not Mr. Boehner or President Obama can marshal their troops in order to deal with our long-term fiscal concerns, in the event that the Mayan timetable proves to be no more accurate at predicting the future than my 2011 Worlds Cutest kittens calendar was–is well beyond my powers of prognostication.

I find myself equally puzzled by the prospect of this nation enduring further economic hardships as a result of government inaction caused by the irrational self-serving behavior of a handful of political hacks that have no true sense of either patriotism or public service. So the big question remains, are we better off striking that grand bargain, or would we be better served by taking a leap of faith off that pecuniary plateau?

The results of the November election strongly suggest that Americans long for those compromises that will restore stability and faith in the marketplace. But as is often the case, deals that are acceptable to both parties, while they make for great signing ceremonies, tend to inadequately address our problems. So perhaps a bit of a free fall after the first of the year might not be such a bad thing. I’m all for giving a new Senate and Congress the chance to spread their wings. Who knows, they may even take the nation to new heights.

But just in case they are unable to live up to my optimistic metaphors, and we hit our heads on the next dept ceiling and come crashing down to the canyon’s floor–here is a bit music from our friend Matt De Blass to help soften the landing.

Matt De BlassClick on Matt’s picture or the title to hear his original uplifting Irish ditty – “Bartender I’ll Have What the Man on the Floor Has Been Drinking

Posted by: Chris Poh

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Remembering 9/11

Today we remember all those who perished as a result of the terrorist attacks against the United States of America of September 11th, 2001. We pray for the continued wellbeing and healing  of the families, and all those who were directly impacted by this tragedy. We honor those that responded with the utmost bravery and commitment to their fellow-man in the midst of the crisis. And we thank those who remain in harm’s way and always faithful to the mission of safeguarding our freedom and security. 

We will raise a glass, and say a prayer for all those who can no longer join us at the table.

 

Published in: Uncategorized on September 11, 2012 at 11:30 am  Leave a Comment  
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