There's nothing like some academic euphemism to get me going on a Sunday morning. The Times had an essay about the "torture" of "waiting on line." Nothing new with that headline, of course. But the theme of the piece was how "experts" were sharing their knowledge about how they defuse the anger for long waits. They want to make the "queuing experience" bearable. Well there's no bearable about it. Never was, never will be. Waiting on line is the Chinese water torture of the 21st Century.
The folks at Disneyland, for example, snake the line for Space Mountain and lie about how long the wait is (by saying it's longer than it really is) to keep the troops happy. Screw that. (I remember waiting for Space Mountain when my son was a little kid, and after an hour when we got to the top of the ride, he chickened out. I told him to go down and wait with his mother because there was no way I was waiting an hour and not going on it.)
Let me start by lauding my dentist's office, which over 30 years now, has kept me waiting for an aggregate amount of time of maybe 10 minutes. Yes, that's not a fantasy folks. I think once in maybe a 150 or so appointments, I was kept waiting once -- for maybe 10 minutes. And they were extremely apologetic about it. This is a busy office with four dentists, several hygienists, and a great reputation. If I'm running even five minutes late, I call and apologize, too. They respect my time; I respect theirs. If they can do it, the rest of the world can, too. They knew how to keep the trains running on time, and they even planned for emergency visits.
Once, after waiting an hour for a doctor, I threw a hissy fit in the office and loudly announced I was going to bill them an hour for my time. People in the waiting room looked blankly at me.
I have never learned patience when it comes to somebody wasting my time on line. Today, we wait, wait, wait and this is lost time we're never going to get back, and yeah, I've read a lot of good books waiting on line. Still...
I think the three obscure scientists who invented the speaker phone (its origins are unclear, however) should probably be awarded the Nobel Peace Prize. Whenever I'm on hold, I'm on speaker, and I can actually do some other mindless task while I'm waiting for an actual human voice to pick up. Truthfully, this has saved me from going berserk, or at least breaking another handset, on more than one occasion.
About the only think I don't mind waiting for any more is getting on an airplane that I'm about to jump out of. I know, it's weird and I'm a bit wacko. But at least I don't have to take off my sneakers and wait on a security line where somebody is going to profile me, frisk me, put me in some metal detection chamber, and then make me feel like I should thank him for allowing me to board.
Sunday, August 19, 2012
Wednesday, July 4, 2012
The Industrial De-evolution
It's the Fourth of July and my microwave oven is broken again. No surprise. Three weeks ago, the washing machine went down, and a few months before that the refrigerator stopped dead. When the washer drum refused to spin, I called the Maytag repairman -- remember him? He was never busy because his appliances were always so reliable, at least in the old TV commercials.
So the guy comes to look at the washer (it had broken down before, and I had a circuit board replaced to get it going again), and he after 15 minutes or so says it will cost more to fix it than replace it. How old was it? Was it under warranty? Twelve years old, and, of course, not under warranty. Yeah, these "older" machines are a problem, he said. It cost me $140 to find all this out.
But back to the microwave, which is at the core of my rant today. When we upgraded the kitchen a few years ago, I opted for the GE Spacemaker, a fancy top-of-the-line model that did everything but buy the popcorn. It cost about $500. Right after the warranty expired (just over a year old) in 2010, the automatic venting door stopped working. I called the GE repair guy, and he said I needed a new part, and using his handheld computer, he informed that the total for replacing the "grill assembly"-- parts and labor -- would be $522.17. I had checked on line and found that the same microwave was now discounted to about $350. The good news was that I could apply the $120 for the service call toward the cost.
I told him to take a hike, and did what I do best. I wrote a very nasty letter to Jeff Immelt, GE's CEO, saying that I'd never buy another GE product ever again. Though I knew that his administrative aide would read the letter and pass it on to some division manager, I used my best exaggerated logic. I'll quote the salient part of my argument: "Imagine someone telling you, Mr. Immelt, that repairing the fender on your $45,000 Audi would cost $47,000. You’d find that somewhere between pathetic and laughable. That’s how I felt when the repairman visited."
A week later, I got a call from some hapless middle manager in the south, in the GE products division, who promptly arranged to FedEx the part overnight and have a repair scheduled at no additional charge.
Now, today, it's on the fritz again. The control touch pad on my microwave is frozen, and despite my best efforts to troubleshoot it (there are lots of suggestions for consumers online), I can't nuke anything at all. I'd welcome your suggestions, short of taking a sledge hammer to this sorry product. (Someone on line suggested I take it apart and clean the circuit board, something I'm totally unqualified to do.)
I've learned two things from this episode:
First, my advice to any young man or woman who is unemployed with a college degree to go into appliance repair work. You need no experience, and you can be a complete dumbo. Just get a good tool box with a Phillips head and flat head screwdriver. Spend a few minutes unscrewing a few panels, tell the customer it can't be repaired, and charge $120 for the "labor."
Second, American-made, or American-assembled products, which we know are really manufactured in emerging nations or China, just don't work for a long period of time any more. We no longer care about quality, and I know that "planned obsolesence" has been an industrial philosophy since the 1960s. But now, it's out of hand. Soon, warranties will be for 24 hours, and your electronic product will die in two months.
One more thing: if your grandparents still have a 40- or 50-year-old refrigerator still working in the basement, don't discard it. The upgrade will only break your heart.
So the guy comes to look at the washer (it had broken down before, and I had a circuit board replaced to get it going again), and he after 15 minutes or so says it will cost more to fix it than replace it. How old was it? Was it under warranty? Twelve years old, and, of course, not under warranty. Yeah, these "older" machines are a problem, he said. It cost me $140 to find all this out.
But back to the microwave, which is at the core of my rant today. When we upgraded the kitchen a few years ago, I opted for the GE Spacemaker, a fancy top-of-the-line model that did everything but buy the popcorn. It cost about $500. Right after the warranty expired (just over a year old) in 2010, the automatic venting door stopped working. I called the GE repair guy, and he said I needed a new part, and using his handheld computer, he informed that the total for replacing the "grill assembly"-- parts and labor -- would be $522.17. I had checked on line and found that the same microwave was now discounted to about $350. The good news was that I could apply the $120 for the service call toward the cost.
I told him to take a hike, and did what I do best. I wrote a very nasty letter to Jeff Immelt, GE's CEO, saying that I'd never buy another GE product ever again. Though I knew that his administrative aide would read the letter and pass it on to some division manager, I used my best exaggerated logic. I'll quote the salient part of my argument: "Imagine someone telling you, Mr. Immelt, that repairing the fender on your $45,000 Audi would cost $47,000. You’d find that somewhere between pathetic and laughable. That’s how I felt when the repairman visited."
A week later, I got a call from some hapless middle manager in the south, in the GE products division, who promptly arranged to FedEx the part overnight and have a repair scheduled at no additional charge.
Now, today, it's on the fritz again. The control touch pad on my microwave is frozen, and despite my best efforts to troubleshoot it (there are lots of suggestions for consumers online), I can't nuke anything at all. I'd welcome your suggestions, short of taking a sledge hammer to this sorry product. (Someone on line suggested I take it apart and clean the circuit board, something I'm totally unqualified to do.)
I've learned two things from this episode:
First, my advice to any young man or woman who is unemployed with a college degree to go into appliance repair work. You need no experience, and you can be a complete dumbo. Just get a good tool box with a Phillips head and flat head screwdriver. Spend a few minutes unscrewing a few panels, tell the customer it can't be repaired, and charge $120 for the "labor."
Second, American-made, or American-assembled products, which we know are really manufactured in emerging nations or China, just don't work for a long period of time any more. We no longer care about quality, and I know that "planned obsolesence" has been an industrial philosophy since the 1960s. But now, it's out of hand. Soon, warranties will be for 24 hours, and your electronic product will die in two months.
One more thing: if your grandparents still have a 40- or 50-year-old refrigerator still working in the basement, don't discard it. The upgrade will only break your heart.
Thursday, June 14, 2012
Let's profit from our own nitwitedness and lunacy
Congress is always creating new fees, new taxes, lying about both, disagreeing on whether a tax hurts the poor or, god help us, arguing about whether a tax makes the rich slightly less wealthy. Thus, we have the proverbial logjam, and ensuing debt, a growing deficit, and various collateral financial damages. Is there any wonder why you can't get two Nobel economists to agree on how to fix the fiscal crisis? I think I have the answer, and it is readily adaptable to the European Union nations. (Are you listening Greece, Italy, and Spain?)
It took a long series of inner monologues, but here is my epiphany.
We create the GST, or "Graduated Stupid Tax." It will be a two-tier levy, the first based on stupid talk, the second on stupid actions. Stupid actions will be taxed at a higher rate than stupid talk, of course. But the graduated part of the tax is directly related to the stupid person's net worth. Thus, if Mark Zuckerberg or Donald Trump says or does something stupid, they are taxed at a higher rate than an ordinary citizen -- namely, you or me -- would be. So, for example, if Zuckerberg shows up at an important business meeting wearing a hoodie, or Trump brings up the Obama birthing issue for a third time, we would tax the bejesus out of them.
If you do or say something stupid, and you realize and cop to it right away, you get a reduction in the scheduled levy. Anyone who goes on a reality show would have to pay a pre-stupid tax. Politicians caught directly doing ridiculously puerile things would be taxed at the highest rate -- think Eliot Spitzer, Newt Gingrich, or John Edwards. Anyone who runs for President? Stupid tax. Anyone dumb enough to get elected and take the job? Special stupid surtax.
We would have to create a new federal office, probably called the "Department of Stupidity," or DOS. Okay, I can hear you cackling. We already have dozens of those! But this would be unique. We would have a bi-partisan commission of dozens of directors from all walks of life and all professions. The only prerequisite for nomination would be never holding elective office above dog catcher. I'd toss out Jay Leno as a possibility for starters, just because he ferrets out incredibly stupid utterances every week in his popular "Jaywalking" interviews. Maybe a gray hair like CBS host Charles Osgood, who always seems to be intelligent-sounding and fair-minded on Sunday mornings. George Clooney? Hugh Laurie? Keith Richards? The only two real requirements are having a low threshold for stupidity and a fairly high level of introspection and humility.
I know this is way outside of the box thinking, folks. But big problems call for bold solutions. There is no dearth of stupidity in this country; indeed around the world. Can you imagine how fast the U.S. treasury would be raking it in? We could balance the budget and erase the deficit in less than three years.
It took a long series of inner monologues, but here is my epiphany.
We create the GST, or "Graduated Stupid Tax." It will be a two-tier levy, the first based on stupid talk, the second on stupid actions. Stupid actions will be taxed at a higher rate than stupid talk, of course. But the graduated part of the tax is directly related to the stupid person's net worth. Thus, if Mark Zuckerberg or Donald Trump says or does something stupid, they are taxed at a higher rate than an ordinary citizen -- namely, you or me -- would be. So, for example, if Zuckerberg shows up at an important business meeting wearing a hoodie, or Trump brings up the Obama birthing issue for a third time, we would tax the bejesus out of them.
If you do or say something stupid, and you realize and cop to it right away, you get a reduction in the scheduled levy. Anyone who goes on a reality show would have to pay a pre-stupid tax. Politicians caught directly doing ridiculously puerile things would be taxed at the highest rate -- think Eliot Spitzer, Newt Gingrich, or John Edwards. Anyone who runs for President? Stupid tax. Anyone dumb enough to get elected and take the job? Special stupid surtax.
We would have to create a new federal office, probably called the "Department of Stupidity," or DOS. Okay, I can hear you cackling. We already have dozens of those! But this would be unique. We would have a bi-partisan commission of dozens of directors from all walks of life and all professions. The only prerequisite for nomination would be never holding elective office above dog catcher. I'd toss out Jay Leno as a possibility for starters, just because he ferrets out incredibly stupid utterances every week in his popular "Jaywalking" interviews. Maybe a gray hair like CBS host Charles Osgood, who always seems to be intelligent-sounding and fair-minded on Sunday mornings. George Clooney? Hugh Laurie? Keith Richards? The only two real requirements are having a low threshold for stupidity and a fairly high level of introspection and humility.
I know this is way outside of the box thinking, folks. But big problems call for bold solutions. There is no dearth of stupidity in this country; indeed around the world. Can you imagine how fast the U.S. treasury would be raking it in? We could balance the budget and erase the deficit in less than three years.
Tuesday, May 29, 2012
The shame of the Olympic Games
Several years ago on a trip to Greece, we visited Olympia, and I stood on the ancient site where the first athletes wrestled. This was my sport in high school and college, and I felt a sense of awe as I stood on the hallowed ground. Excuse the cliches, but I feel like I was touching a great part of the history of civilization.
So, now to today's gripe, which has been building up for some time. The New York Times had a front page story in today's sports section about a teenager training for this summer's London Games on his BMX bicycle. Yes, this is an Olympic sport, and one with a tradition of about fifteen minutes compared with something like tossing a discus, a javelin, and wrestling.
I'm a realist and a progressive, and I understand the need to keep the games modern, commercial, and in touch with our times. But the money and the TV and subsequent professionalization of the athletes have so completely overwhelmed the spirit of the games and competition that I've finally had enough. I'm not even going to watch the classic events. I'm gone as a viewer, and I don't really care which country, which athletes, win gold or otherwise.
The politics of which sport gets in and which does not have really killed my taste for this quadrennial spectacle. Softball is now gone. But BMX biking is in. Why? Well, it's telegenic, it gets sponsorship, it means money and spectators, so it's like letting a kiddie version of NASCAR inside the gates. Softball, alas, does not do all that.
The tradition has long been eroding, but now it is completely gone. A sport like squash racquets, which (full disclosure -- I play for fun and exercise) has been around for 120 years or so. Squash officials have been petitioning the Olympic committee for entry into the games for several years now. They are continually denied. The sport has world class athletes in several countries -- including, Pakistan, the UK, and Australia -- and is widely played in dozens of countries which would attract a viewership. I know, I know. There's no money in squash. There is in tennis, and that's why tennis is in the Olympics.
I once read an article about a marathoner who was training for the Games, and he was quoted as saying that the long-distance runners were a different kind of fraternity, one where there was a real fondness for their fellow competitors. He said that the uniforms and numbers didn't even matter. They would all run in white T-shirts and shorts and they'd know who was who. It was all about character and the journey, and not about the medals, and certainly not about money and the TV rights.
We've certainly come along way since those early days in Greece, haven't we. Unfortunately, the distance we've traveled hasn't amounted to much.
So, now to today's gripe, which has been building up for some time. The New York Times had a front page story in today's sports section about a teenager training for this summer's London Games on his BMX bicycle. Yes, this is an Olympic sport, and one with a tradition of about fifteen minutes compared with something like tossing a discus, a javelin, and wrestling.
I'm a realist and a progressive, and I understand the need to keep the games modern, commercial, and in touch with our times. But the money and the TV and subsequent professionalization of the athletes have so completely overwhelmed the spirit of the games and competition that I've finally had enough. I'm not even going to watch the classic events. I'm gone as a viewer, and I don't really care which country, which athletes, win gold or otherwise.
The politics of which sport gets in and which does not have really killed my taste for this quadrennial spectacle. Softball is now gone. But BMX biking is in. Why? Well, it's telegenic, it gets sponsorship, it means money and spectators, so it's like letting a kiddie version of NASCAR inside the gates. Softball, alas, does not do all that.
The tradition has long been eroding, but now it is completely gone. A sport like squash racquets, which (full disclosure -- I play for fun and exercise) has been around for 120 years or so. Squash officials have been petitioning the Olympic committee for entry into the games for several years now. They are continually denied. The sport has world class athletes in several countries -- including, Pakistan, the UK, and Australia -- and is widely played in dozens of countries which would attract a viewership. I know, I know. There's no money in squash. There is in tennis, and that's why tennis is in the Olympics.
I once read an article about a marathoner who was training for the Games, and he was quoted as saying that the long-distance runners were a different kind of fraternity, one where there was a real fondness for their fellow competitors. He said that the uniforms and numbers didn't even matter. They would all run in white T-shirts and shorts and they'd know who was who. It was all about character and the journey, and not about the medals, and certainly not about money and the TV rights.
We've certainly come along way since those early days in Greece, haven't we. Unfortunately, the distance we've traveled hasn't amounted to much.
Sunday, March 18, 2012
The stupid bar, lower than ever during campaign season
Like most folks, I usually throw out the raft of daily junk mail without even opening it, silently praying for trees. Oh, I don't really do that. Just trying to get your attention. But when stuck for a rant, occasionally I will open one and actually read it.
On Friday, I decided to take a look at the latest detritus from Democratic National Headquarters. It is campaign season, and the crap also rises in a very bipartisan balloon. So I was very intrigued when the teaser read: "Enclosed: Democratic Party Ballot to Save Medicare." (Boldface theirs.) I was instructed to complete and return it before April 9, 2012, as if the Republicans were going to erase this entitlement shortly thereafter.
Okay, don't worry, my Republican friends. I knew right away this was Nancy Pelosi asking me for money. But again, I was desperate for a rant, and I knew I'd find something in this pitch to really piss me off.
I was asked to check three boxes, the first beginning, "YES, leader Pelosi, I will help protect Medicare..." Oh god, she's my comrade now. The second was to complete the ballot (as if this was a vote that really counted for something). And the third -- you guessed it! -- send money.
But here's what really got me angry. The stupidity level of the ballot questions. The first was, "I believe Medicare is an unbreakable bedrock promise and a vital social safety net on which millions of Americans depend and for which they worked their whole lives." Strongly agree, and so on, were the multiple choices. Well, we all strongly agree, don't we, even if the last part is ridiculous (anybody working before 1965 didn't know it was an entitlement because it wasn't yet law). But the next ballot question -- about House Democrats working with Obama to lower the price of prescription drugs (duh, another good idea that they have no control over) was another stupid one. And the third, well, was just blatantly a Republican bashing rallying cry, which I didn't really mind. Do they really spend money to tally the results?
I guess what really bothers me is not the bait-and-switch kind of plea for a party donation. Both the GOP and the Dems do this sort of thing every day. It's the ridiculousness of the ballot subterfuge and the stupidity of the questions. Does anyone with an intelligence level low enough to take this seriously actually have enough money to give to a political party of any stripe? I hope not.
The other takeaway from this is how polling questions make me crazy, as well. No matter how carefully and judiciously you frame the question, they are almost always leading towards a biased answer. Re-read that sentence if you care. I'm not even blaming the pollsters -- they're merely jury-rigging them in a subtle way so their clients feel better (rather than give them a true picture of where the people stand on a candidate or an issue). So when you see the results of an opinion survey -- no matter how prestigious the polling organization appears to be -- pay close attention to the plus or minus margin of error. It's almost always bigger. People change their minds all the time -- we're flip-floppers, too -- not to mention all the people who lie just to get the questioners off the phone.
On Friday, I decided to take a look at the latest detritus from Democratic National Headquarters. It is campaign season, and the crap also rises in a very bipartisan balloon. So I was very intrigued when the teaser read: "Enclosed: Democratic Party Ballot to Save Medicare." (Boldface theirs.) I was instructed to complete and return it before April 9, 2012, as if the Republicans were going to erase this entitlement shortly thereafter.
Okay, don't worry, my Republican friends. I knew right away this was Nancy Pelosi asking me for money. But again, I was desperate for a rant, and I knew I'd find something in this pitch to really piss me off.
I was asked to check three boxes, the first beginning, "YES, leader Pelosi, I will help protect Medicare..." Oh god, she's my comrade now. The second was to complete the ballot (as if this was a vote that really counted for something). And the third -- you guessed it! -- send money.
But here's what really got me angry. The stupidity level of the ballot questions. The first was, "I believe Medicare is an unbreakable bedrock promise and a vital social safety net on which millions of Americans depend and for which they worked their whole lives." Strongly agree, and so on, were the multiple choices. Well, we all strongly agree, don't we, even if the last part is ridiculous (anybody working before 1965 didn't know it was an entitlement because it wasn't yet law). But the next ballot question -- about House Democrats working with Obama to lower the price of prescription drugs (duh, another good idea that they have no control over) was another stupid one. And the third, well, was just blatantly a Republican bashing rallying cry, which I didn't really mind. Do they really spend money to tally the results?
I guess what really bothers me is not the bait-and-switch kind of plea for a party donation. Both the GOP and the Dems do this sort of thing every day. It's the ridiculousness of the ballot subterfuge and the stupidity of the questions. Does anyone with an intelligence level low enough to take this seriously actually have enough money to give to a political party of any stripe? I hope not.
The other takeaway from this is how polling questions make me crazy, as well. No matter how carefully and judiciously you frame the question, they are almost always leading towards a biased answer. Re-read that sentence if you care. I'm not even blaming the pollsters -- they're merely jury-rigging them in a subtle way so their clients feel better (rather than give them a true picture of where the people stand on a candidate or an issue). So when you see the results of an opinion survey -- no matter how prestigious the polling organization appears to be -- pay close attention to the plus or minus margin of error. It's almost always bigger. People change their minds all the time -- we're flip-floppers, too -- not to mention all the people who lie just to get the questioners off the phone.
Sunday, February 19, 2012
The Sneaky Opt-In Culture of the Web
"Why do we need your email?" So I clicked to find out. "The Clymb is a private member network. Pricing arrangements with our partner brands require that our low prices are only available to members of The Clymb. We need this information to establish your membership, but your information is kept strictly private. We do not share, rent, or sell our members' personal information."
This outfit may be totally legitimate, but I'm not buying. It reminds me of being a member of Price Club or any of the big box stores, where "membership" to a retailer is merely a function of paying an annual up-front fee. This is where companies earn their profits and sell you bulk items at low margins and steep discounts. It also reminds me of the brick-and-mortar merchant that asks you for your email address or phone number when you charge an item (for "security purposes"). I used to just say no rather than complain to the poor teenaged clerk. Now I give them a wrong number. I confess I'm trying to throw wrenches into this continual process of data mining for commercial purposes.
My point is this: Most of us have become accustomed to getting angry at the concept of having to "opt out" rather than "opt in." So the marketeers are now using stealth methods to get you to opt in. As soon as I see a bunch of blank fields with little red asterisks, unless I absolutely crave the product or need the service, I am clicking as far away from the site as I possibly can.
E-commerce has a lot of good qualities and an attraction that I need not recap here. But beyond the incredible amount of spam that even the best screening programs can't keep up with, it has become a merchant mart where sellers are using surreptitious techniques to get your email address (and usually a lot more personal information).
Then it's incumbent on the user to opt out. Even opting out is not always that easy. The more unscrupulous ones make you jump through hoops to do so, and then probably sell your email address anyway (or keep you on the list for other related companies). Why do companies even bother asking you to check a box about why you're leaving? Especially the ones that offer the choice "because I didn't sign up in the first place." The ones that really are annoying finally tell you that you've successfully opted out, but it will take up to "10 business days" to get you off the their email list. Oh. Really. It takes 8 seconds to get on the list and 10 days to get off it? The honest purveyors at least auto-unsubscribe customers right away.
This outfit may be totally legitimate, but I'm not buying. It reminds me of being a member of Price Club or any of the big box stores, where "membership" to a retailer is merely a function of paying an annual up-front fee. This is where companies earn their profits and sell you bulk items at low margins and steep discounts. It also reminds me of the brick-and-mortar merchant that asks you for your email address or phone number when you charge an item (for "security purposes"). I used to just say no rather than complain to the poor teenaged clerk. Now I give them a wrong number. I confess I'm trying to throw wrenches into this continual process of data mining for commercial purposes.
My point is this: Most of us have become accustomed to getting angry at the concept of having to "opt out" rather than "opt in." So the marketeers are now using stealth methods to get you to opt in. As soon as I see a bunch of blank fields with little red asterisks, unless I absolutely crave the product or need the service, I am clicking as far away from the site as I possibly can.
E-commerce has a lot of good qualities and an attraction that I need not recap here. But beyond the incredible amount of spam that even the best screening programs can't keep up with, it has become a merchant mart where sellers are using surreptitious techniques to get your email address (and usually a lot more personal information).
Then it's incumbent on the user to opt out. Even opting out is not always that easy. The more unscrupulous ones make you jump through hoops to do so, and then probably sell your email address anyway (or keep you on the list for other related companies). Why do companies even bother asking you to check a box about why you're leaving? Especially the ones that offer the choice "because I didn't sign up in the first place." The ones that really are annoying finally tell you that you've successfully opted out, but it will take up to "10 business days" to get you off the their email list. Oh. Really. It takes 8 seconds to get on the list and 10 days to get off it? The honest purveyors at least auto-unsubscribe customers right away.
Wednesday, February 1, 2012
One reason why healthcare is so expensive....
Answer to the riddle? (Question on the Facebook teaser: What's the difference between a popsicle stick and a tongue depressor?) About $6.
There are a dozen good explanations for why our healthcare system has spiraled into the depths of hell -- and I'm sure there's some measure of validity to all of them -- but I'd like to recount one from the trenches that you might find useful and informative.
Some time ago, I woke up with my elbow swollen and tender. Though I wasn't in any pain, my wife convinced me that it looked weird and deformed so I should probably get it examined. I had banged into a wall the previous day playing squash and thought I could have injured it in some way. I trekked to the ER at Roosevelt Hospital (closest one to my apartment), and was lucky that it was a weekday during lunch hour. No line at all and I was taken immediately. The doctor on duty X-rayed it and found "nothing to worry about." He suggested icing it to reduce the swelling and then following up with my regular internist. Co-pay: $50. Time spent: 45 minutes.
Icing it did not reduce the swelling, so after a few days, I went to see my regular doctor. He looked at it and said, "Oh, you have a bursa." According to one definition, "A bursa (pl. bursae) is a small fluid filled sac that decreases the friction between two tissues. Bursae also protect bony structures." The swelling was due to excess blood in the joint, and it needed to be drained. But, of course, he didn't do any draining himself. He mainly listens to complaints and types into his computer. He recommended a "specialist." Co-pay: $15. Time spent: 15 minutes.
I got an appointment with the referral, a Russian doctor, a woman in her 50s or 60s. She looked at it, and said, yes, a bursa, and it had to be drained. Before the simple procedure she spent a long time asking me about my medical history, and she took copious notes. Then she used three or four needles to extract the blood. I was impressed with her thoroughness. She recommended taking vitamin D supplements because I was getting up there with age and deficiencies came with the territory. Co-pay $15. Time spent: 1 hour.
This took two weeks and cost $80 out of pocket, and a lot more to the healthcare insurer. (Meaning all of us.) Oh, and when I received the financial statements from my HMO, it had knocked down the Russian lady doctor's reimbursement to about $65 (from about $250 claimed). She had done the most labor to treat my injury, and she received the least amount of compensation. What's wrong with this picture, folks?
After I was cured, I ran into one of my softball buddies, Dr. Mark Melrose, a terrific physician who had just opened an Urgent Care Clinic in my neighborhood. As soon as I began telling him my story -- literally, a minute into it -- he guessed, "Oh, a bursa."
Thirty or forty years ago, I would have gone to my family doctor and it would have been taken care of in one visit -- not three, and probably not a hospital visit -- and it would have cost a lot less, even in adjusted dollars.
Of course, the hospital ER doctor misdiagnosed my injury. He could have figured out what was wrong by just Googling "swollen elbow." But he was covering his ass by simply doing an X-ray, which didn't reveal a fracture.
What does this story tell us?
The system is designed for referrals. It's designed for specialties. It's designed for fear in taking responsibility for treatment. It's designed for inefficiency. And it's designed to cost us far more money than is necessary. And this is one reason it is bankrupting the country.
There are a dozen good explanations for why our healthcare system has spiraled into the depths of hell -- and I'm sure there's some measure of validity to all of them -- but I'd like to recount one from the trenches that you might find useful and informative.
Some time ago, I woke up with my elbow swollen and tender. Though I wasn't in any pain, my wife convinced me that it looked weird and deformed so I should probably get it examined. I had banged into a wall the previous day playing squash and thought I could have injured it in some way. I trekked to the ER at Roosevelt Hospital (closest one to my apartment), and was lucky that it was a weekday during lunch hour. No line at all and I was taken immediately. The doctor on duty X-rayed it and found "nothing to worry about." He suggested icing it to reduce the swelling and then following up with my regular internist. Co-pay: $50. Time spent: 45 minutes.
Icing it did not reduce the swelling, so after a few days, I went to see my regular doctor. He looked at it and said, "Oh, you have a bursa." According to one definition, "A bursa (pl. bursae) is a small fluid filled sac that decreases the friction between two tissues. Bursae also protect bony structures." The swelling was due to excess blood in the joint, and it needed to be drained. But, of course, he didn't do any draining himself. He mainly listens to complaints and types into his computer. He recommended a "specialist." Co-pay: $15. Time spent: 15 minutes.
I got an appointment with the referral, a Russian doctor, a woman in her 50s or 60s. She looked at it, and said, yes, a bursa, and it had to be drained. Before the simple procedure she spent a long time asking me about my medical history, and she took copious notes. Then she used three or four needles to extract the blood. I was impressed with her thoroughness. She recommended taking vitamin D supplements because I was getting up there with age and deficiencies came with the territory. Co-pay $15. Time spent: 1 hour.
This took two weeks and cost $80 out of pocket, and a lot more to the healthcare insurer. (Meaning all of us.) Oh, and when I received the financial statements from my HMO, it had knocked down the Russian lady doctor's reimbursement to about $65 (from about $250 claimed). She had done the most labor to treat my injury, and she received the least amount of compensation. What's wrong with this picture, folks?
After I was cured, I ran into one of my softball buddies, Dr. Mark Melrose, a terrific physician who had just opened an Urgent Care Clinic in my neighborhood. As soon as I began telling him my story -- literally, a minute into it -- he guessed, "Oh, a bursa."
Thirty or forty years ago, I would have gone to my family doctor and it would have been taken care of in one visit -- not three, and probably not a hospital visit -- and it would have cost a lot less, even in adjusted dollars.
Of course, the hospital ER doctor misdiagnosed my injury. He could have figured out what was wrong by just Googling "swollen elbow." But he was covering his ass by simply doing an X-ray, which didn't reveal a fracture.
What does this story tell us?
The system is designed for referrals. It's designed for specialties. It's designed for fear in taking responsibility for treatment. It's designed for inefficiency. And it's designed to cost us far more money than is necessary. And this is one reason it is bankrupting the country.
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