Tag Archives: healthcare

Keeping America Ugly

Now that healthcare reform has been passed into law, we’ve seen full-blown outrage from conservative commentators, teabaggers, and unnaturally orange-skinned people (…a tax on indoor tanning??  How will we keep the Jersey economy afloat?).  This trifecta has argued that as healthcare poison gets jammed down our throats, the country will almost certainly spiral into a welfare state of doom.

Even though I can’t identify with teabagging, Beck-watching fist pumpers, I do have some concerns about the healthcare reform.  On the whole, I agree with the concept: everyone should have access to healthcare.  But like any government plan, this reform is riddled with unintended consequences.  By forcing insurance on the 46 million who are currently uninsured, we also introduce moral hazard into the system: now that those people have insurance, they may be more likely to do stupid things, like give birth to octuplets or get the (golf) clap from Tiger Woods.

To solve this problem, there should be a greater focus on preventative measures.  For example, I am a rather repulsive high-volume eater.  When we go out to eat, my family often orders 7 entrees for 4 people.  One time, we were asked to move to a bigger table so that the restaurant could accommodate all the food.  A few months ago, a friend and I went out to dinner in Union Square, where we split a fried appetizer, each ate a huge entree (I got a pork chop), and then ordered a bread pudding to share… but the dessert was so good that we ordered another one (and ate it all).  That night, I had to sleep sitting up in my bed.

I never count calories, I rarely exercise, and I’ve been known to unbutton my pants at the dinner table.  Essentially, I am a rather disgusting example of American excess, flying in the face of our mission to Keep America Beautiful.  But even with all that, I’m not (yet) a blubbery whale.  I can still fit into clothes that I wore in high school, and I can wear skinny jeans without being ironic.  At the same time, I’m totally testing the system.  Eventually, nature and logic will have its way with me, and I’ll end up ferrying my fat self around on a scooter that you will pay for through your taxes.  So in order for you to make me change my atrocious ways now, you need the system to punish me.  Because unless it’s costing me something  significant today, I won’t stop eating mac and cheese in bed.

There are promising preventative statutes included in the plan now (like the tanning tax), but we could use more of these so-called Pigovian taxes: cigarette taxes, alcohol taxes, soda taxes, candy taxes, etc.  I’m sure that the ultra-conservative Pigou Club would argue that the negative externalities associated with unhealthy people is minimal… but now that we have a universal healthcare system, perhaps they’ll reconsider.

Punishing bad behavior is controversial, yes.  But I ate 3 steaks in 3 days this past weekend, and I think we can all agree — that’s not just bad, it’s ugly.

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Do You Want Fries With That EKG?

Everywhere we go, Americans are used to getting the up-sell: “Do you want fries with that burger?” … “Would you like to buy an extra coffin while it’s on sale?” … “How about a silencer for your new handgun?”  It seems that we can never escape the hordes of people telling us that we want more, need more, must buy more.  As every truism is brought to life by a Beyonce song, it’s fitting that salespeople always want to Upgrade U.

So, instead of buying a regular package, we’re compelled to buy the Gold, the Platinum, the Supreme, Extreme, Marginally Better But Has a Cool Metallic Name So Must Be Worth It package.  And with aggressive salespeople pushing the up-sell, we’re often shamed into buying things we don’t actually need.  We buy two ShamWows instead of one.  We send a letter with delivery confirmation, insurance coverage, and a limited-edition stamp featuring Roseanne Barr.  We get mozzarella sticks.

The up-sell… it fools us every time.

Are there any places where we don’t get the up-sell?  I used to think so.  I used to think that doctors were honest people, filled with good intentions and the sole ambition to save lives.  And for most of my life, this belief held true.  But then I moved to New York City, and I was proven wrong.  Doctors are just salespeople with advanced degrees and the ability to scare you with a scalpel.

Last August, I decided that I would go in for a check-up.  I had just recently moved to New York, so I found a doctor through my health insurance company.  The guy seemed legitimate enough: undergrad at University of Pennsylvania, med school at Michigan.

The first red flag was when I entered his “office” — located in the basement of an apartment building.  Basement offices are not uncommon in New York City, except that most are occupied by tarot card readers and dog fighting rings.  But I disregarded this as a product of the recession, and introduced myself to the doctor’s secretary as “the 9 AM.”

The next red flag was when I met with the doctor himself.  He was a kind, older gentleman, who seemed like the type of guy who would end up in a nursing home and forget his grandkids’ names.  He took down all my information by writing it on a blank yellow legal pad.  “Name?” … “Age?” … “History of diabetes?”  Now, I know that digitized medical records may be a thing of the future, but the doctor wasn’t even filling out some kind of standardized form.  He didn’t even measure my height and weight.  I could have told him that I was 6’4″ and weighed 300 lbs, and he would’ve written it down on his trusty notepad.

After the doctor penned an essay on my medical history, we finally got to the examination.  He used a stethoscope to listen to my breathing.  All of a sudden, the doctor stopped, looked at me with concerned eyes, and told me that I had a heart murmur.

A heart murmur.

This is what happened next:

I ask the doctor what that is.  He says that it’s a condition that could lead, eventually, to death.  I ask the doctor if this is something that I could just develop.  No, the doctor says that I probably had it since birth.  I ask the doctor why no one has ever caught this before.  Well, it’s very delicate, he says, and it’s hard to hear it sometimes.  I ask the doctor if, perhaps, he should turn off the fan in the examination room.  The doctor says I should get an electrocardiogram.

Ah, the up-sell.

I didn’t get an EKG.  But, it’s hard to say no to extra fries when we’re dealing with our health.  (Especially when the fries are getting paid for by insurance companies.)  If I dropped dead from a heart murmur, I would feel terrible for not listening to my crackhead doctor.  I would also be dead.  Lose-lose.

So, that’s why up-selling doctors do it — it prevents them from getting sued, and the bill is covered by someone else.  But the practice isn’t just to cover the doctors’ butts: it’s also immensely lucrative.  Last December, I went to the dentist to get a simple cleaning.  A month later, my insurance company got the bill.  One of the items listed on the invoice was $146 for “Oral eval”… the dentist had used a digital camera to take four pictures of my mouth.

Of course, I ordered the Dentist Supreme.

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Top 10 Signs You Should Get a New Job… Top 10 Pickup Lines For Accountants

I had to write some Top 10 jokes for a project I’m working on (entitled, “leaving finance”), so here they are!  Also, a reader asked for more accounting jokes, so I included my Top 10 accountant pickup lines as well.  Please let me know if you attempt them, as I would like to chart out the success rate in a spreadsheet.  I’m forecasting zeros, but you never know.

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Top 10 Signs You Should Get a New Job

10. Your boss calls you “Employee #243.”

chainedpen9. When you finally leave at 9PM after twelve hours in the office, your co-worker asks, “Taking a half day?”

8. Bonuses are taxed at 40% and paid out in Venezuelan bolivars.

7. All your office supplies are chained to the desk.

witchdoctor6. The CEO makes decisions about layoffs with a Ouija board and a Magic 8 ball.

5. Employees have the option of trading in company shares for a bag of Skittles.

4. The healthcare plan only covers visits to witch doctors and accredited shamans.

3. Company memos include the following disclaimer: “We are not responsible for asbestos-related illnesses.”

2. Your office is in Pittsfield, MA.

1. The 20-year anniversary gift is a shotgun.

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Top 10 Pickup Lines Used By Accountants

10. Your body is like the perfect balance sheet, except that you have no liabilities.accountant

9. You’re just like revenue… I don’t want to defer you any longer.

8. If I could rearrange the alphabet, I would put U and I near Enron, so we could take it down together.

sales7. My job is to tell clients that they can’t spend money.  Lucky for you, I don’t work for myself.

6. Hey baby… Did you know that consolidated entities get significant tax breaks?

5. I’ll work you over like the buttons on my calculator.  I hit ‘em hard and  I hit ’em quick, and I always get the right answer.

4. I don’t care if you’re rich or poor, because I will make your cash flow.

3. I have incredibly liquid assets right now, and they’re dying to get a good return.

2. Want to come back to my place and work on Sexcel?

1. Sales aren’t the only thing rising today.

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Just a Good, Old-Fashioned Town Hall… With the Crazies

Remember when we used to have town halls to discuss trivial matters? — Like how to get the neighbors off your lawn, or where to host the July 4th fireworks?  Well, we’ve evolved since then… now, town halls are all about whether the government should allow Grandma to live.  From yesterday’s meetings in Pennsylvania, Missouri, and New Hampshire, it appears that public sentiment (or at least the sentiment of the old and jobless who can attend these midday town halls) is clear: We want Grandma to live!  We’re not going to let Obama’s death panels take her!!  Bring your socialist friends back to Russia!!!  WE… ARE… AMERICA!!!!! (Thunderous applause, chants of “USA”, hootin’, hollerin’, waving of American flag… or, if wearing a patriotic-themed shirt, some saggy boob-shakin’)

jerryspringerOf course, Grandma was never in danger yesterday… unless she found herself in the middle of the angry mob.  I was more afraid for Grandpa Specter (D-Penn), who turns 80 in February, and who hosted his second town hall in Lebanon, PA.  Wearing a dark black suit (he had a death panel meeting in the afternoon), Specter gallantly stood a foot away from his constituents as they railed him about budget deficits, tort reform, and his flippy floppies.  One particularly hostile man invoked God before making his dramatic exit.  After an hour in front of that crowd, I half-hoped that a loony Russian socialist would euthanize ol’ Arlen right there, and put him out of his misery.

Given that the morning session in Pennsylvania was so fun, I had to tune in for Senator McCaskill’s (D-Mo.) town hall in Missouri.  McCaskill one-upped Specter with some drama of her own: an African-American supporter with a sign was attacked, then escorted out of the room amidst cheers.  McCaskill did her motherly best to shush the crowd, but her scolding led to even more disorder.  Appealing to a higher power (“Remember, we had a prayer in the beginning!”), McCaskill still couldn’t prevent the boos, the interruptions, and the frequent appeals that she just “go home.”  Perhaps the attendees simply wanted to have a good Christian hee-haw without Mom getting all huffy about healthcare reform.

While Obama’s town hall in New Hampshire was infinitely more civil (although someone did bring a gun), it all begs the question: Why the outrage?  Do people really believe that Obama is going to put down Grandma?  That the government wants to emulate the (gasp) old Soviet Union?  Never mind that most Western Europe countries have universal healthcare…  I suppose the fear that we’re turning into Britain (the redcoats!) no longer stokes a fire in most Americans. 

Along with the crazies, I too, have legitimate concerns with a universal healthcare plan… But, as long as Grandma gets to live, I’m willing to listen.

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The Presidential Debate Redux, With Michael Scott

TOM BROKAW: Good evening from Belmont University in Nashville, Tennessee.  I am Tom Brokaw of NBC News.  Welcome to the second presidential debate of this campaign season, sponsored by the Commission on Presidential Debates, AIG, and Dick Fuld’s compensation package.  As you have noticed, this is the first ever debate to feature not only the two presidential candidates, but also a representative of middle America, Michael Scott of the Dunder Mifflin Paper Company.  Welcome, Senator Obama, Senator McCain, and Mr. Scott. (polite applause)

MICHAEL SCOTT: Tom, I would prefer that you address me as Senator Scott.

TOM BROKAW: (long pause)…Uh, okay, let’s get started.  The first question is to Senator Obama.  This from Oliver Clark.  Oliver asks: Through this economic crisis, most of the people that I know have had a difficult time.  How is this bailout package actually going to help these people out?

SENATOR OBAMA: Thanks Tom.  Oliver, first, let me tell you what’s in the rescue package for you. Right now, the credit markets are frozen up and what that means, as a practical matter, is that small businesses and some large businesses just can’t get loans.  If they can’t get a loan, that means that they can’t make payroll. If they can’t make payroll, then they may end up having to shut their doors and lay people off.  And if you imagine just one company trying to deal with that, now imagine a million companies all across the country.  So it could end up having an adverse effect on everybody, and that’s why we had to take action. But we shouldn’t have been there in the first place.

SENATOR McCAIN: I’d like to jump in here.  My friends, Oliver’s question is a good one.  You know, the match that lit this fire was Fannie Mae and Freddie Mac. I’ll bet you, people like Allen and Mr. Scott here probably never even heard of them before this crisis.

MICHAEL SCOTT: (perplexed)Who’s Allen?

SENATOR McCAIN: See?  So, Fannie and Freddie were the match that started this forest fire.  Some of us stood up against it. There were others who took a hike.

TOM BROKAW: Thank you Senator McCain.  Mr. Scott, do you have anything to add?

MICHAEL SCOTT: Tom, again I would prefer it if you addressed me as Senator.  And yes, yes I do have something to add.  You know, I run a paper business out in Scranton, Pennsylvania.  While Fannie and Freddie are out there lighting fires, guess who, or more importantly, what–is getting burned?  That’s right: paper.  And you know what will happen if these forest fires don’t get extinguished?  No more paper. (McCain nodding somberly) Now, I’ve taken a hike before, don’t get me wrong.  There are many beautiful trails outside of Scranton.  But if we keep having these fires, what’s going to happen to these trees that overlook the trails?  Whoa, big fire, (simulates fire with hands) Smokey the Bear can’t save us, ahhh–there goes the paper!  There go the trees!  There go the trails!  Now I’m out of both a job and an enjoyable weekend hobby.

TOM BROKAW: …Right.  OK, next question.  Senator McCain, in all candor, do you think the economy is going to get worse before it gets better?

SENATOR McCAIN: My friends, we can fix our economy. Americans’ workers are the best in the world. They’re the fundamental aspect of America’s economy.  They’re the most innovative. They’re the best–they’re most–have best–we’re the best exporters. We’re the best importers. They’re most effective. They are the best workers in the world.

TOM BROKAW: (confused) OK… Senator Obama?

SENATOR OBAMA: Part of the problem here is that for many of you, wages and incomes have flat-lined. For many of you, it is getting harder

MICHAEL SCOTT: That’s what she said!

SENATOR OBAMA: (looking pissed) Excuse me?

MICHAEL SCOTT: Sorry, that’s just a thing I do, I–you know, OK, so seriously–the economy.  I mean, I live a pretty good life.  I don’t own 8 cars or anything, but I do own my own condo, I run my own branch of Dunder Mifflin, AND (pointing to stomach) I am a soon-to-be father.

TOM BROKAW: Congratulations, but we really need to get on–

MICHAEL SCOTT: (continuing) Now, do I want to raise my child in a country where America is #2?  Where we’re sitting at home, looking up as Madagascar laps us in the recyclable paper business?  No, no–that is not what I want for my child.

TOM BROKAW: Thank you Mr. Scott.

MICHAEL SCOTT: (wagging finger) Tom???

TOM BROKAW: (reluctantly)…Senator Scott.  Let’s move on.  Next question, Senator Obama: There are some real questions about whether everything can be done at once.  Health care, energy, and entitlement reform–give us your list of priorities.

SENATOR OBAMA: Terrific question, Tom.  We’re going to have to prioritize, just like a family has to prioritize. Now–

SENATOR McCAIN: (interrupting) Hey look, we’re not–we’re not–we’re not rifle shots here.  We are Americans. And I think you can do all three at once.

MICHAEL SCOTT: (whispering) That’s what…

TOM BROKAW: That’s enough.  We’re moving on.  Our last question is from a hippie in New Hampshire.  She asks: As president, how will you know what you don’t know and what will you do when you figure out that which you don’t know?  Senator Obama, I’ll start with you.

SENATOR OBAMA: Tom, one of the things that we know about the presidency is that it’s never the challenges that you expect. Here’s what I do know: I know that if the economy continues to struggle, Mr. Scott over here is going to have a tough time keeping up with the mortgage payments on the condo he’s got.  His firm may soon be facing the real possibility of having to let some people go.

We can’t expect that if we do the same things that we’ve been doing over the last eight years, that somehow we are going to have a different outcome.  We need fundamental change. That’s what’s at stake in this election.

MICHAEL SCOTT: (looking fearful) Will there still be enough money for a Christmas party?

SENATOR McCAIN: My friends, there are challenges around the world that are new and different and there will be different–we will be talking about countries sometime in the future that we hardly know where they are on the map, some Americans. (Michael Scott nods emphatically)

When times are tough, we need a steady hand at the tiller and the great honor of my life was to always put my country first. And–and–you know who is going to raise our taxes and take away Christmas?  That one.  (points at Senator Obama)

MICHAEL SCOTT: (running from stage) Noooooooooooooo!!

TOM BROKAW: And that concludes tonight’s debate from here in Nashville.  We want to thank Belmont University, the Commission, and the traffic light operator for tonight’s debate.  There is one more opportunity for the talking heads to give their stump speeches: next Wednesday, October 15, with host Ryan Seacrest and musical guest Akon.  Good night everyone.

(NOTE: All text in black is what was actually said, taken from the CNN transcript of Tuesday night’s debate.)

 

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