Our new president has been promising for a long time to “make America great again.” Two things happened today that inspired me with suggestions on how he could begin.
One concerned the downfall of a famous television commentator, and the other the unwieldy state of our health-care system.
After decades of bloviating about important issues in our own country and internationally to a large audience of gullible, simple-minded folks incapable of thinking between the extremes of black and white, Fox News’ Bill O’Reilly has met his demise. The pattern of sordid and insensitive treatment of women has ended conservatism’s TV reign by these folks’ hero. Numerous women fearful of this bullying media titan’s power have come forward to tell stories of sexual harassment, with more on the way predicted, and charges of racism also possibly forthcoming. A big question looms: How will his buddy Donald Trump – excuse me, President Trump – react to the news?
Rewarding failure
One would think that this surfeit of sexual arrogance attributed to O’Reilly would result not only in his firing, but in legal action against him. That may be forthcoming. Meanwhile, he reportedly will receive a $25 million payout to send him on his way – par for the course for high-paid leaders in all walks of American life – business, media, government, sports – who fail. It seems as though the people who make the most money in their jobs also get the most money when underperformance forces them out of those jobs. Give them a lot of money so they won’t make waves on the way out appears to be the motivation behind these buyouts. Yes, I suppose it often has to do with contractual obligations – but there has to be a better way.
Maybe I wasn’t aware enough of what was going on at the time, but I don’t recall such exorbitant severance packages meted out to business executives and leaders in other fields in bygone days. One reason for that might be that they weren’t paid nearly as much in proportion to the underlings in the same fields. CEOs, for example, weren’t making 350 times their average employees, as they are now. America should go back to the good old days, when the people who produced the products or services were deemed to be worth more than a tiny fraction of the person who guided the organization.
The Factor: ex post facto
President Trump
Donald Trump’s mantra on The Apprentice was you’re fired, and the person who got the boot didn’t get the booty. Come on, Donald, you wield a lot more power now. How about doing something to rectify this gross imbalance in compensation for job performance in American life?
Another way in which President Trump could retroactively improve the lot of Americans is to make our health-care system function more like it did before costs began shooting skyward. In this social arena, he could do things to make that system work better than ever. Currently, a bureaucratic nightmare exists by which patients with, say, a bladder problem cannot go (no pun intended) directly to a urologist unless they are on an expensive plan, but must instead get approval from their primary care physician (PCP) first. What ensues is a series of screw-ups that puts the patient in the middle of two warring factions which blame each other when the referral cannot be located. I’ve had several appointments negated by such bungling.
Sick health-care system
A prime example of this abysmal deficiency in our system is the process I have undergone for the past 15 weeks in having cataract surgery. It’s been that long since the ophthalmologist agreed surgery was necessary, and it’s not over yet. First, the doctor I chose said he used only the laser, not the scalpel. That was good, I told him. What he didn’t tell me was that it cost an extra three thousand bucks. I learned that after wasting two weeks and at least $150 for copays and refraction. So I chose another doctor in the practice. Just before the surgery on one eye was due, the surgical coordinator asked me where the clearance for surgery from my primary doctor was. She’d faxed the request, she said. Stupid me. I’d relied on the two doctor offices to coordinate that between themselves. The woman gave me one hour to get the clearance, or the surgery would be postponed. I raced 15 or 20 miles to the PCP’s office, causing two near collisions, only to find that all but one employee had left for the day (closed at noon Fridays), and she didn’t want to cooperate. In fact, she lectured me about the off-the-cuff, inopportune comment I’d made to a woman in the corporate office that I’d called in advance, to the effect that my utter exasperation was driving me to thoughts of suicide. The doctor’s employee warned that I could be arrested and detained under the Baker Act. Fortunately for me, I’d seen the doctor on another matter only days before, and she found the ophthalmologist’s fax, then faxed the doctor’s report to that office. I raced back, and the surgical coordinator nonchalantly told me everything was good to go.
Fast forward seven weeks. Surgery on the other eye was scheduled for April 24. I had to undergo clearance again, and did so last week. Yesterday, Wednesday, the new surgical coordinator called to find out where the clearance was. I called the PCP’s office, and the phone was busy. I called again, and the nurse told me they’d faxed it. So I called the coordinator, who was tied up. Finally, I reached her, and she said she’d received no fax. I called the PCP again, and was told they’d just faxed it. I called the coordinator again, and she hadn’t received it. I waited, and called again. This time, she’d received it.
Clear the swamp
Ladies and gentlemen, this is madness. You’d think that with a system this inefficient, the costs at least would be low. But they’re high, and climbing ever higher. Trump and his congressional cohorts in the GOP don’t care; they want to make it worse. It can be fixed. A large and growing number of Americans favor the single payer system – expanding Medicare to all. Some experts have warned it would be quite costly to convert. But it could be paid for with higher taxes on the wealthy, not lower ones, as Trump and the GOP want. And once in effect, it would likely be less costly than the current system, based on the experience in Europe and elsewhere, where health-care costs are half those in the U.S.. As a bonus, it would be far less aggravating.
It’s totally out of the range of possibilities, at least for now. Maybe after the 2018 elections, if enough people come to their senses and shove a sufficient number of Republicans out of Congress. We can hope, but more than that, make our voices heard. It’s happening, and it’s proving effective.
