Panea giveaway

https://www.quikly.com/panera/s/YKGgjwBm?utm_content=blogger

https://www.quikly.com/quicken-loans/s/vrAxmzqA

https://www.quikly.com/quicken-loans/s/vrAxmzqA?utm_content=blogger

This will probably jink them, but GO JAYHAWKS!!!!!

http://www.youtube.com/watch?v=2Pn1PqC6XQg

Scratch that, start over

I haven't posted anything in a while, probably because I have not had much to say, and partly because the last midwest pizza trip got boring for me to write. I have recanted that story in another spot on the web, so I didn't feel like repeating myself. As soon as I find something worth saying, I will put it down here. In the meantime, peace, joy and love to you.

Midwest Pizza Pilgrimage, Take 2

Last year in May, my family made a trip up from the Kansas City area through Iowa, Illinois, and Wisconsin. I documented on this blog 5 pizzas freom 5 different pizza restaurants that we sampled along the way. This year in April, we made a similar trip. However, this time, the trip took us to the Chicago suburb of Schaumburg, IL. We (or at least I) again sampled 5 different pizzas from 5 different pizzerias. The pizzas varied in style from Midwest thin/crackery crust to deep-dish to Neapolitan. The most part, I stuck to my usual toppings of sausage (Italian, if possible) and mushrooms.

Stop # 1 - Perna's Pizza

Our first stop was in Rock Falls, Illinois. We noticed a sign for Perna's Pizza so we drove in and arrived at opening time on a Friday. We were the only customers in this quaint, old family restaurant that looked like it had been around for 40+ years (a stone outside was dated 1962). Taking a look at the menu we ordered a regular sausage and mushroom pizza. My wife ordered a salad and we were given complimentary bread while we waited. The salad was most likely from a plastic bag. I asked if the bread was homemade and was told "yes". I'll mention more about the bread later. I noticed after had ordered that Perna's had pizza slices available for lunch - had I known or been told that fact earlier, I would have opted for 1-2 slices instead. Our pizza was ready in about 15 minutes.


The style of pizza here is decidedly a Midwestern/Bar-style, thin, crackery crust based. My initial impressions were of a similar pizza we had eaten a year earlier at Primo Joe's Pizza in Dixon, IL on our previous trip in 2009. However, I have to say that after a couple of bites, all links to any other pizza I might have eaten in my lifetime were broken. In a nutshell, the pizza we had at Perna's was totally bland, devoid of any flavor from crust to toppings. The mushrooms were the canned variety. The sausage was flavorless, let alone having any spice or redeeming quality to it. The sauce was minimal, but what little I could taste might have had some flavor to it. As for the bread I mentioned earlier, it was equally devoid of flavor as the pizza, perhaps more so. I suspect they use the same dough for their bread as their pizza dough.

It is difficult to put into words my impressions of Perna's Pizza. Was it bad? Well, it certainly wasn't good. It's hard to describe an eating experience when there is no flavor on which to comment.

All in all, I would not go back, nor recommend it to anyone who still had their taste-buds intact. Not a good way to start off a pizza crawl across the cornbelt of America.

March 22, 2010

I have been absent from writing here for quite a while. I guess I just wanted some time to see how things would turn out in the big debate on health-care reform in the United States.

The title of this entry is the date because of what I think will be an important day for history of the USA. Will it be a day of infamy or a day that forever changed health-care for the better, that is yet to be decided.

I, personally, am not sure how things will turn out, and I am not altogether pleased with everything that went into and were left out of this bill. But, based on my previous entry, those folks who read this will hopefully understand when I say something had to be done. Because

1) There are too many average citizens losing ground when it comes to maintaining their own and their family's health-care and insurance

2) Too many other countries on this planet have found a way to make things work better. Not perfect, but better, and why shouldn't the US be able to make things better?

3) Had the status quo simply been maintained, the country would have been bankrupted by the current fee-for-service health-care system anyway.

This bill passed by the House is at least a jumping off point to what will hopefully be changes that will continue to improve health-care provided to all the citizens of this country.

On a final note, I would just like to add a few more personal comments.

I was born and raised in this country, and therefore I have been afforded many luxuries that many people of this world will never have or even see. I believe in God. I believe in doing the right thing and what is best for the people, not just for Mad Ernie. I believe doing what is right is not always what is best for me financially or in any other way.

There is far too much fear going on in the world today, especially in the United States. Change not only comes, but it comes at a faster rate than at any other time in the world's history. People fear change. They fear the unknown. I understand that. But fear often leads to anger, and then to hatred. I am quite sure that is not a good thing. My biggest hope for the future of the United States of America now is for people to live with less fear and be willing to listen and discuss differences. Debate, yes. But yell, scream, threaten, and try to instill fear in others ... that is just not good.

Health-Care

When I started this blog, I was not planning on getting into very heavy subjects like politics, religion, etc. but I still left the door open to that possibility. It appears the hot topic of the day is health-care in the U.S.A. Having heard, read about, worked in, and experienced the current health-care system, I decided it was time to stop playing it safe and begin a series on this blog about health-care in this country.

To start with, as I have previously stated, I am a white, Anglo-Saxon, protestant living in the suburban Midwest of the United States. I was born in this country, as were my parents. I grew up in a lower-middle to middle-class household that was a) loving, b) protestant-Christian, and c) Republican. I have a college-plus formal education, am married, and have one very cute little girl. I began working in health-care part-time in 1985 and have continued to work in health-care since that time in a variety of capacities from health-care worker, professional, educator, researcher, consultant, provider, and in the corporate sector of health-care products. There, now you know my background.

The health-care issue in America is not a new one. I have heard comments about it since I was a little boy, and they have grown in frequency and harshness since that time. Generally speaking, the majority of comments I’ve heard and read about our health-system is that it is broken. Perhaps severely broken. Perhaps even irreparably broken. Having witnessed what the health-system has done to strangers and family alike, my leaning is to agree that health-care in this country is woeful and badly in need of change.

A Country in Trouble: the U.S.S.R.

The health-care issue currently facing our country and how we choose to tackle it is, in my opinion, the single most important thing citizens of this nation will face now and in the next 5-10 years. To put the issue into perspective, let me use an analogy:

For decades in the 20^th century, the “great enemy” of the United States was perceived to be the Union of Soviet Socialists Republic, i.e., the Soviet Union. Beginning in the late 1970’s and early 1980’s, the Soviet Union’s commitment to their military increased at a larger rate. The invasion of Afghanistan and the continued problems within the Eastern bloc European countries led to a greater need for money for military support. And there was also the need to maintain the arms-race with the United States. According to one source, the decline and fall of the USSR began in 1985. As stated in this summary on the Wikipedia website:

”After years of Soviet military buildup at the expense of domestic development, economic growth was at a standstill. Failed attempts at reform, a stagnant economy, and war in Afghanistan led to a general feeling of discontent, especially in the Baltic republics and Eastern Europe.”

And

“To match the USA's military buildup, the Soviet Union increased its own military spending to 27% of its GDP and froze production of civilian goods at 1980 levels.”

As another web-author states:

“… their economic planning failed to meet the needs of the State, which was caught up in a vicious arms race with the United States.”

And to summarize

“By 1990 the Soviet government had lost control over economic conditions. Government spending increased sharply as an increasing number of unprofitable enterprises required state support and consumer price subsidies to continue. Tax revenues declined as republic and local governments withheld tax revenues from the central government under the growing spirit of regional autonomy. The anti−alcohol campaign reduced tax revenues as well, which in 1982 accounted for about 12 percent of all state revenue. The elimination of central control over production decisions, especially in the consumer goods sector, led to the breakdown in traditional supplier−producer relationships without contributing to the formation of new ones. Thus, instead of streamlining the system, Gorbachev's decentralization caused new production bottlenecks.”

And so, a number of factors, largely economic or with economic repurcussions led to a people and economy that could not sustain itself. Deficit spending being one of them. Opening up free-markets didn’t help. Bottlenecks on production of outgoing goods like oil helped to starve the economy. And so, bye, bye Soviet Union. Information can be found at these and many other websites and books:

http://www.fsmitha.com/h2/ch33.htm

http://en.wikipedia.org/wiki/History_of_the_Soviet_Union_(1985%E2%80%931991)

http://www.coldwar.org/articles/90s/fall_of_the_soviet_union.asp

So what lessons might the U.S. learn from this history lesson? If recent quote figures are accurate, health-care in the U.S. currently makes up approximately 17-20% of the gross domestic product (GDP). Here is what the National Coalition of Health-Care has said:

In 2008, total national health expenditures were expected to rise 6.9 percent -- two times the rate of inflation.¹ Total spending was $2.4 TRILLION in 2007, or $7900 per person¹. Total health care spending represented 17 percent of the gross domestic product (GDP).

U.S. health care spending is expected to increase at similar levels for the next decade reaching $4.3 TRILLION in 2017, or 20 percent of GDP.

1. Keehan, S. et al. “Health Spending Projections Through 2017, Health Affairs Web Exclusive W146: 21 February 2008.

To add some comment and perspective to these percentages, here is one author’s comment (from The Book titled "Solving The American Health Care Crisis" to be published in 2009) http://www.eyeuniversal.com/eyeuniversal/HealthcareSolutions/summary.html:

Per dollar America spends much more and gets much less in return than other affluent Western nations when it comes to health care spending. It is time for the American policymakers to stop bragging about their health care system and start acting on their hollow promises to find real solutions to health care crisis. It is expected that the United States health care spending would reach nearly 20% of GNP within next 10 years, which is unsustainable.

Commentator Mark Pauly has this to say about the percentage of the GNP that is made up of health-care costs http://content.healthaffairs.org/cgi/reprint/12/3/152.pdf

The key point, however, is that high medical services cost even if it should account for 14 percent, or 20 percent, or even 24 percent of GNP–is not bad per se. A problem arises if and only if medical services are worth less than the forgone consumption of other goods and services.

To Mr. Pauly’s comment I say, all well and good. But given how the rise of health-care costs out-paces inflation in the United States by at least double, then one has to question is the health-care being provided in the United States worth it? Are average American citizens getting twice the bang in their health-care for their buck? If you are reading this, then I surmise a good majority of you are saying “no”.

How It Began

One question that often comes to mind at this point is “who is responsible for such a rapidly rising costs of health-care in the United States?” I am not sure at this point that looking for blame is a worthwhile exercise. Time is too short for such activities. But I will endeavor to briefly summarize what I think led to the current state of affairs with runaway health-care costs, and believe me, there is plenty of blame to go around. These include:

• Health-care providers: Physicians, hospitals, and other health-professionals who are given a license, and thereby a monopoly, to practice and charge whatever they think is right. What is ‘right’ is a relative concept. Basically, since everything runs a fee-for-service system, what is ‘right’ is whatever the market may bare. This includes visits to physicians’ offices, medications and other medicinal products, all kinds of procedures, and basic overall patient care.


• Insurance providers: They are for-profit companies designed like any for-profit company – to make a profit. And, as with all entities in a capitalistic, free-enterprise system, more profit is always better. The insurance companies have been gaining much attention in more recent times. Although they have blame to share in the result of health-care costs, they cannot bare all of it. There is plenty to go around.


• Lawyers: Law-suits and the resulting amount of insurance protection an average physician has to pay in the United States is staggering. There have no doubt been many lawsuits brought against health-care providers for their negligence that were justified. But at the same time, there have probably been as many lawsuits that were frivolous or unfair to the health-care provider. And what made these lawsuits so plentiful? One big reason is the cost of health-care on the part of the provider. A patient might be more willing to forego such action if the damage were not permanent and costs them very little. When the costs of even routine procedures today run in the tens-of-thousands-of-dollars and above, coupled with a health-care provider’s can-do-no-wrong attitude, then patients are more inclined to want to sue.


• Patients: No one is exempt from blame on the issue of rising health-care costs, even John and Jane Q. Public. In the United States, the average citizen expects the best because of the amount of money that is poured into health-care every year. Labor unions and their employers have long used health insurance as a big negotiating tool from which to bargain with. Also, new technologies and therapies for diagnosing and treating diseases receive news attention every day, giving rise to the typical American’s attitude of deserving the best, whatever that may be. Dealing with failure or death in the United States is not accepted. Health in the United States is treated like another other obstacle in an American’s life: it is to be dealt with and overcome. Failure is not an option, not for the patient nor the provider. And despite expert opinions on individual patient cases, laws and lawsuits force the issue over in favor of whatever the patient wants and generally is more expensive. I suggest that such attitudes have led to an unhealthy outlook and approach to dying and death in this country. Given my time spent in health-care with other professionals and being married to a hospital chaplain, I know I am not alone in this thought.


• Politicians and Lobbyists: Some are elected, some are simply hired guns, but in the end, the bureaucracy does its best to avoid major changes. Making small changes to placate the masses is what it’s all about in politics. Big changes run the risk of a) failure of themselves, and b) getting you voted out of office. Is it any wonder previous presidential administrations have failed at some form of universal coverage for the nation’s citizens? Also, with the plethora of paid lobbyists on capital hill these days, it pays to follow an axiom which I find has served me well in recent years: follow the money. Or as the famous Bobbi Fleckman once put it: money talks and bullshit walks.

The Argument

For decades, Americans have been arguing the virtues of universal health-care versus the current fee-for-service system. The original health-care system put into place in the United States ran pretty much the same as any other business. The advent of health insurance made it possible for people who could not pay out of pocket at the time services were rendered to engage a third party into the mix to pay on their behalf. And so it went. The capitalistic free-market system would allow for competition and therefore pricing would be kept in line, just as with any other good or service. But what once was a nice added benefit to most jobs has become a major important, if not the factor to all employees: health care benefits. As the years have rolled on, benefits for the majority of people who still have health insurance have dropped while co-pays have dramatically increased, along with the general cost of doing business in the health-care system.

As Americans began living longer, and Medicare and state Medicaid programs became more utilized, costs for health-care services became so out of control that the government enacted a system for Medicare recipients in 1983 called DRGs: diagnostic related groups. The system was designed to curb the vast differences in charges being levied against the Medicare system for all types of treatments for diseases. Standardization became the norm for medical treatment. Your patient has bronchitis? You get $50. Outpatient pneumonia? That’ll get you $100 for treatment. Knee-replacement? That’s worth $1000. If the service provider (physician, hospital, etc.) had fees that were higher than what the DRG paid, too bad. You’ll have to talk to the patient, you're not getting anymore from us.

Since that time, private insurance companies have adopted similar methods of reimbursement for health-care services and materials. However, given the number of different insurers in the U.S., the criteria and other parts of such a strategy vary from provider to provider. These different sets of rules for each player in the health-care provider arena has necessitated health-care providers (hospitals, long-term care facilities, individual physician practices) hiring on more individuals who can navigate the various systems and help to expedite payment, thereby further adding to the cost-burden of the health provider. And of course, they often try to pass this additionally cost back on to the customer, i.e., the patient, thereby further increasing the economic burden on Joe Public.

The vast majority of changes that have come to the American health-care system have been under a fee-for-service mentality and strategy. That is to say, in most cases, health-care providers and their patients are not rewarded for getting or staying well. They are only rewarded (monetarily) when someone walks in who is sick. All money is generated based on use of services and products to treat an already present illness, not in preventing that illness. In more recent years, health insurers, health-care providers, and employers have tried to come up with creative ways of providing incentives to people to maintain a healthy life-style. To be fair, on a national scale, I am not aware of what impact these incentives have had, if any.

The Best Money Can Buy?

One group with an axe to grind regarding health-care in the United States and advocating for universal health-care is the Connecticut Coalition for Universal Health-care. Look at the following website for some information they provide: http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm

Here is a sample of what they have to say:

1. Myth One: The United States has the best health care system in the world.

· Fact One: The United States ranks 23rd in infant mortality, down from 12th in 1960 and 21st in 1990

· Fact Two: The United States ranks 20th in life expectancy for women down from 1st in 1945 and 13th in 1960

· Fact Three: The United States ranks 21st in life expectancy for men down from 1st in 1945 and 17th in 1960.

· Fact Four: The United States ranks between 50th and 100th in immunizations depending on the immunization. Overall US is 67th, right behind Botswana

· Fact Five: Outcome studies on a variety of diseases, such as coronary artery disease, and renal failure show the United States to rank below Canada and a wide variety of industrialized nations.

· Conclusion: The United States ranks poorly relative to other industrialized nations in health care despite having the best trained health care providers and the best medical infrastructure of any industrialized nation

One could argue they have a particular bias towards Universal Health-Care, however, they are certainly not the only ones to point out the failings in access and quality of health-care in America. For checking their facts and figures, I suggest checking out a few other readily found sources and you likely will find the Connecticut Coalition has been even conservative in some estimates:

The Central Intelligence Agency’s Factbook data:

http://www.indexmundi.com/united_states/infant_mortality_rate.html

https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

A Wikipedia summary:

http://en.wikipedia.org/wiki/Infant_mortality

The Centers for Disease Control and Prevention (CDC):

http://www.cdc.gov/nchs/data/databriefs/db09.pdf

http://www.cdc.gov/nchs/data/hus/hus08.pdf#026

CNN:

http://www.cnn.com/2009/HEALTH/06/11/life.expectancy.health.care/

Other sources:

http://www.infoplease.com/world/statistics/life-expectancy-country-2009.html

Therefore, if the United States continues on a path of spending towards health-care that continues at an increased rate and does not provide any better quality, then one would have to logically conclude the United States economy will be completely bankrupt within the next 4-8 years, especially given the current overall economic downturn in the country and the increased spending on the part the federal government to maintain life-support for the nation. Lest we forget, the baby-boom generation (1946-1964) is going to begin retiring soon in 2011 and there will be plenty of elderly adults who will be needing, wanting, and expecting some amount of health-care. And according to some sources, rising, not flat-lining is what is expected for the rate of health-care costs, and logically so:

http://www.concordcoalition.org/tabulation/why-health-care-costs-will-continue-rise

http://wallstreetblips.dailyradar.com/story/report_health_care_costs_to_rise_9_pct_in_2010_yahoo/

With that in mind, and the preponderance of data to support a need in change of the US health-care system, one must conclude that change is not only necessary, it is inevitable. Change is hard thing for most people. As uncomfortable as we may be with a situation, human tendency is to be even more fearful of change to the unknown.

A History of Universal Health-Care in the United States

Lest anyone think this topic is something new in this country, I invite you to check out the following websites:

http://www.pnhp.org/facts/a_brief_history_universal_health_care_efforts_in_the_us.php

http://www.businessweek.com/bwdaily/dnflash/jan2006/nf20060123_1965_db013.htm

http://www.politifact.com/truth-o-meter/statements/2009/mar/05/barack-obama/Obama-goes-back-to-his-Republican-roots-on-health-/

As part of the Progressive Movement in the early part of the 20^th century, Theodore Roosevelt, a Republican, was the first U.S. president on record to support some form of national health insurance. Health care was the 11th issue listed under "Social and Industrial Justice," after occupational safety, a child labor prohibition, a minimum wage, "one day's rest in seven" and other progressive ideas which we now take for granted in the United States.

Franklin D. Roosevelt, a Democrat, was the next president to try and attempt health-care coverage for citizens. But with the Great Depression and greater concern about unemployment, Social Security, and the New Deal, propositions were removed or strongly opposed right up to World War II.

Harry Truman was the president who followed FDR and was perhaps the most in favor and tenacious of supporting a form of universal health-care in the United States. Here is an excerpt from the first weblink above:

Truman’s plan for national health insurance in 1945 was different than FDR’s plan in 1938 because Truman was strongly committed to a single universal comprehensive health insurance plan. Whereas FDR’s 1938 program had a separate proposal for medical care of the needy, it was Truman who proposed a single egalitarian system that included all classes of society, not just the working class. He emphasized that this was not “socialized medicine.” He also dropped the funeral benefit that contributed to the defeat of national insurance in the Progressive Era. Congress had mixed reactions to Truman’s proposal. The chairman of the House Committee was an anti-union conservative and refused to hold hearings. Senior Republican Senator Taft declared, “I consider it socialism. It is to my mind the most socialistic measure this Congress has ever had before it.” Taft suggested that compulsory health insurance, like the Full Unemployment Act, came right out of the Soviet constitution and walked out of the hearings. The AMA, the American Hospital Association, the American Bar Association, and most of then nation’s press had no mixed feelings: they hated the plan. The AMA claimed it would make doctors slaves, even though Truman emphasized that doctors would be able to choose their method of payment.

In 1946, the Republicans took control of Congress and had no interest in enacting national health insurance. They charged that it was part of a large socialist scheme.

Therefore, the idea that universal health care coverage for Americans is an idea that began with Democrats Barak Obama, or Bill and Hillary Clinton, is wrong.

How and why did these previous attempts fail? Look back at 1946 and Harry Truman's opponents. Largely due to lobbying on the part of people who thought they had the most to lose (i.e., money and control), namely the physicians and folks in health-care who had made a fine living off of the status quo. The American Medical Association, along with others, created a great deal of uproar and pushback to the idea of national healthcare over the last century. Even lawyers know it would mean a severe decline in lawsuits, just as it does in the Veteran's Administration system. In addition, conservatives then, as now, used campaigns aimed at invoking fear in the public, particularly with the use of the words “socialism” and “communism” to derail any attempt at such a system.

One of the burning questions that people in this country must put out on the table and get out of their system is the following: is health-care of all citizens of this country an individual right, or a privilege? Other countries of this world have seemed to answer with an obvious answer of "it is a citizen’s right". Within all of this, though, in my opinion there is something more at stake than politics and the economy. There is the age old question of “Am I my brother’s (or sister’s) keeper?” Do we as human beings, first and foremost, have some kind of duty or obligation to help our fellow human beings when they are in need, particularly when it comes to their own health? Do we let laws, rules, and profit-motive divide us and not address the basic issue of health for our fellow mortals? As I said before, I was raised and am a protestant Christian. Even with the bumper-sticker religious question of "What would Jesus do?", I think it should be clear to most people we cannot simply let things go on as they have. I, for one, would not want to look Jesus (or Moses, or Buddha, or Mohammed) in the eye and say, "Well, we didn't help our fellow human beings because it was their fault anyway, we couldn't afford it, and besides our Constitution didn't really make allowances for it." I have news for folks who keep invoking the US Constitution over moral issues of justice for ALL: the Constitution does not guarentee a lot of things, including a public library system, freedom from being incarcerated, the presence or absence of a social security system, and a host of other things. Justice for all means just that ... for everyone. Not just ourselves or the people we favor over others we don't like.

I am not necessarily a proponent of universal health-care for the United States. Other countries have found their own ways to deal with the issue of health-care for their citizens without using that model and I think this country could do it also, with proper input and dialogue.

Now that I have provided some background and set the stage, I think I’ll stop here. Maybe I'll add more to this review and discussion as the situation in the United States moves along.