Monday, August 31, 2015

Another Set of One-percenters

I had just gotten off the phone with a medical testing facility that I was scheduled to visit three days later.  I explained that the letter I received in the mail, with attached form to fill out and map, asked that I call them and speak to a technician if I answered “yes” to any of the highlighted questions on the form.  (They were all highlighted.)  Since I had two yeses, I called.  They presented no problem and I thought they would not, but told the tech that I was just following instructions.  She said, “Thank you, you would be surprised how many people don’t even read the letter.”

Then I sat down to check headlines and other sources and found this guidance for the estimated 41 million contact lens users from the Centers for Disease Control and Prevention (CDC).  “While contact lenses are usually a safe and effective form of vision correction, they are not entirely risk-free—especially if they are not cared for properly.”  They have a table of about a dozen tips for proper care of contact lenses to avoid eye infection. 

The tips include:
  • ·      Wash your hands with soap and water before touching your contact lenses.
  • ·      Don't sleep in your contact lenses unless prescribed by your eye doctor.
  • ·      Keep water away:  Avoid showering, using a hot tub or swimming.
  • ·      Clean your lenses with disinfecting solution—never water or saliva.
  • ·      Never store them in water.
  • ·      Replace them as recommended by your eye doctor.
  • ·      Replace your contact lens case at least once every three months.
  • ·      Don’t “top off” solution. Use only fresh contact lens disinfecting solution.
  • ·      Visit your eye doctor yearly.
  • ·      Talk to your eye doctor if you having any difficulties.
  • ·       Remove your contact lenses immediately and call your eye doctor if you have eye pain, discomfort, redness, or blurred vision. 


These tips are basic to contact lens maintenance, yet a recent national survey found that more than 99% of the estimated 41 million contact lens wearers in the United States may be engaging in at least one behavior known to increase their risk of eye infections.  Are they so unreasonable or difficult?


Discipline is not just about maintaining an appropriate weight and keeping spending below income.  It’s also about many little things like brushing and flossing, taking precautions to avoid eye infections from contaminated lenses and reading the letter before arriving for the test.  I wonder how much of that 30 minutes I am supposed to arrive early for the test is predicated on the assumption (from experience) that the majority failed to read the letter and didn’t fill out the form.

Friday, August 28, 2015

Gratitude

A key to good perspective is gratitude.  Instead of looking at and yearning for what we don’t have, we take time to appreciate the things we have.  This is not difficult at all in a country with so much to offer.  It is easy to identify these advantages with hindsight of 50 or 60 years, but our economy is introducing new innovations at such a rapid pace that it has reached a point a person need not be very old to remember “the old days when we didn’t have ….”

It has been only about 15 years since the smartphone, as we know it today, was introduced.  It could function like a cellphone but also had e-mail capability as well as browsing (if you could find some place to get access to the Internet).  By contrast, I remember the first time I saw a handheld calculator.  It could add, subtract, multiply and divide.  I think it could even do a square root.  The year was 1972 and it cost $250.  That would be the equivalent buying power of over $1400 today and all it could do were basic functions, but it was sure a lot more convenient than doing the work by hand and more precise than using a slide rule.  I was very impressed.  Now something with the same functionality would be a free promotional item that nobody really wants.  

Going back a little further, my grandparents called a refrigerator an “ice box” remembering a time when the ice man would deliver a large block, which would keep the food cold until it melted and had to be replaced.  Now refrigerators are standard and over 90% of residences are air-conditioned.  That’s a lot of progress in a few generations.  Imagine trying to explain streaming video to Abe Lincoln – not only how it works, but why so many people are willing to pay for it!

The problem is boredom, complacency and taking things for granted.  This article points out that this is not just an American problem; it’s a human problem.  They found that providing poor families in Central and South America with improved housing had only a temporary increase in happiness.  When they were interviewed 16 months later, the researchers found a substantial initial increase in happiness but “eight months after that -- two years after moving to the new housing -- about 60 percent of the increase in happiness goes away.”  This is why after thousands of years of technological innovations, from the printing press to indoor plumbing to smart phones (with an app telling where to get the best deal on your favorite wine), “evidence indicates…that happiness has not really increased over time."


The remedy for this human condition is gratitude.  We have more than our ancestors could have possibly imagined.  That’s something to consider the next time you are driving to the grocery store or a restaurant or a concert in your climate-controlled car and the phone starts playing your favorite ringtone.

Monday, August 24, 2015

Equality, Indeed!

On February 15, 2014 Ray Rice was arrested after he lost his temper and punched his then fiancĂ©e knocking her unconscious.  The news media and social media went crazy.  They were demanding that something be done.  This kind of behavior on the part of a professional football player was unacceptable.  What was the league going to do about it? 

The commissioner took action in the form of a 2-game suspension.  (Note:  “Former Ravens cornerbacks Cary Williams and Fabian Washington earned two- and one-game suspensions, respectively, for similar first-time offenses of domestic violence, though neither was caught on tape.”)  The news media and social media went crazy again.  This was insufficient punishment for such an egregious act.  There were calls for the commissioner’s resignation based on his obvious insensitivity.  The league went into the huddle and came out with a personal behavior policy to standardize the punishment for these outside activities instead of leaving it to the discretion of the coach, owner or commissioner to rule on each according to the situation.

On September 8 the team released him and the NFL gave him an indefinite suspension.  Since then Ray Rice has been unable to play football for any team.  He is now a free agent, but any team that signs him will, according to some reports, likely have to deal with possible public backlash.

On August 11, 2015 IK Enemkpali a linebacker for the New York Jets “sucker punched” his quarterback, Geno Smith, after an altercation in the locker room.  Smith will miss 6-to-10 weeks of the season after suffering a broken jaw from the one-sided confrontation.

Except in the sports news, there was hardly a peep.  Outside of that, the news media made very little of the incident and there was not a ripple on social media.  The coach called the behavior childish and cut Enemkpali from the team.  The next day the Buffalo Bills signed him off waivers for $510,000 for the 2015 season.

Both incidents involved a professional football player losing his temper and striking a defenseless, apparently unsuspecting person.  In one case the woman publicly forgave her attacker and later married him.  In the other case the reaction is unknown because the news coverage was so scant. 


I understand the difference between domestic violence and violence committed in a football locker room, but is it enough of a difference to elicit such vastly different public reactions?  Both broke the law.  Both are bad role models.  It kind of makes me wonder who is pulling our strings and deciding what we should get really upset about and what we should ignore or let pass.

Friday, August 21, 2015

Thoughts and Questions about Money

If a sweater made in the US sells for $85 at a downtown shop and a sweater of the same quality made overseas sells at JC Penney for $35, almost everyone would spend the $35 to be equally warm and stylish for the winter.  It is a reasonable decision.  Your friends and neighbors would likely not call you greedy, but would compliment you for being a smart shopper.  Perhaps a few of your more financially well-healed acquaintances might tell you that you have an obligation to support the American workers by spending more downtown.  That’s fine for those who can afford the luxury of showing their patriotism by throwing away money, but most could use that extra $45 to buy school supplies for the children or to spend on other needs.

What happens, though, when the sweater company that can buy skills in the US for $25 per hour (including benefits) decides instead to buy skills of exactly the same quality overseas?  It is accused of being greedy.  It’s exactly the same behavior, but it is so easy to represent this reasonable decision by a corporation as evil.  Those same well-healed critics may even start a campaign to boycott the greedy sweater company or try to pressure the retailers not to do business with them.  A certain segment of the caring and compassionate public, always eager to show how dedicated they are to concepts like social justice, buy in to the protest and support it.  It is particularly frightening how easily a campaign like this can gain momentum if it pushes the right emotional buttons and uses social media to spread the word, vilifying the target of displeasure, in this case the sweater company or the retailer.

Who then suffers and who benefits?  Assuming the campaign is successful:  the sweater company may have to adjust their business practices or lose business and the retailers may have to make similar adjustments.  A few Americans may be hired, but higher sweater prices will automatically reduce demand.  Fewer sweaters will be sold because the people who could afford only the less expensive sweaters will be forced to find other options to stay warm in the winter.  The well-healed critics will feel smug, thinking they made the world a better place, not caring how many ordinary people are now deprived of the choice they once had.  To do so they must trade off the school supplies to buy a sweater.  No one will care how those people overseas who lost jobs will survive.  Ultimately, was this the right thing to do?  The economic isolationists believe it is.  Often, though, noble concepts such as compassion and social justice lure us into a simplistic misunderstanding of economics, and the outcomes are least just to those who are least well-off.



Another short thought - this one on perspective:  Today the price of gasoline is between $2.50 and $3.00 per gallon in most parts of the US.  That seems high and people like to complain about it.  Older folks remember when it was 29.9 cents per gallon and you could easily refill the tank for about $3.00!  But that was back in the 1960s when you could buy a nice car for about $3,000 and the median family income was around $7,600.  Today (actually from 2013 US Census data) the median income is $52,300 and a nice car still costs almost half that – but the new car gets about twice the miles per gallon as we did back then.  Perhaps it’s not as bad as we think.

Monday, August 17, 2015

Missing the Point on Healthcare

The frustration continues as I listen to politicians argue about what they refer to as healthcare when all they are really talking about is insurance.  They act as if making the insurance affordable will solve the problems of increasing healthcare costs, the need for consistent quality and making the process easier for everyone involved.  The answers to those assumptions are:  doubtful, not likely and definitely not.

First, making it easier to pay for something never brings down the cost.  It increases the demand, which is sure to raise prices unless supply increases correspondingly. 

The government and insurance companies can insist that prices drop by setting limits and restrictions, but that may backfire on the quality side.  As this article points out, one current requirement that hospitals are rated on customer satisfaction is driving some hospitals to “focus on making people happy, rather than making them well.”

Additionally, insurance does not make it easy to do business with hospitals or doctors.  It establishes the dynamic of insurance companies standing between you and your doctor.  You go to the doctor and possibly pay a co-pay charge at the time of the visit.  Then you wait for weeks to receive an explanation (EOB) from the insurance company.  It tells what the doctor usually charges, how much they have agreed to pay, how much the insurance will pay and how much you owe.  If you disagree, you must negotiate with your insurance.  Otherwise you wait a few more weeks until the bill arrives from the doctor and hope it corresponds with the EOB.  Otherwise you negotiate with the doctor’s billing department.  (Don’t complain to the doctor because he or she is busy helping other patients and usually has no clue about the billing process or pricing.) 

This is unlike any other transaction in our lives.  We receive a service without any indication of how much it is going to cost and then wait to see if all the paperwork matches up.  Usually no one can tell you how much it is going to cost and you have no opportunity to “shop around” to other providers based on reputation, services or pricing.  In fact shopping around is discouraged, because the insurance company has negotiated contracts and if you go “out of network” or to a doctor not covered, even if that doctor is cheaper and more experienced, it will cost you more.  (They show you this right on the EOB.  The same is true of dentists, by the way.)


The answer is to reduce (not increase) the role insurance (both government and private) plays in healthcare, to open it up to the consumer (patient) in the same way we buy our food, electronics, auto repairs, airline tickets, haircuts, mortgages and so many other goods and services.  For all these we know the cost up front, our friends and neighbors share their experiences, and if we are not satisfied with any aspect of the transaction, we can go elsewhere without penalty.  Because of this ability to compare and shop around, the price and quality of these are in better control.