Monthly Archives: February 2007

Dentistry, Health Care, and Bildad the Shuhite

I am ill tonight. I am sick to my soul.

Twelve-year-old Deamonte Driver died of a toothache Sunday.

A routine, $80 tooth extraction might have saved him.

If his mother had been insured.

This is not, in and of itself, an unusual story. In 2003, nearly 16 percent of the US population was without health insurance. In the US, health insurance is inextricably linked to employment. If you have a job with good benefits, you’ll have relatively low-cost health insurance. If you have a job without medical benefits, or if you are unemployed, you will pay tremendously for health insurance, assuming you can afford it. If you can’t afford it, you’ll pay more for basic health care than the insured plus their insurance company pays.

Let me say that again. If you do not have health insurance, doctors and hospitals will charge you more than they charge insurance companies. Chances are, you’re like me: you have health insurance. Have you ever looked at the claim reports your insurance company sends you? I happen to have received one today. In the itemization section, there’s the following:

Services Submitted Charges Eligible Charges Benefits Paid
LAB-PATHOLOGY $30.00 $6.971 $6.97

1YOUR BLUE CROSS PREFERRED CARE PROVIDER HAS AGREED TO ACCCEPT THE AMOUNT LISTED IN THE ‘ELIGIBLE CHARGE’ COLUMN AS TOTAL PAYMENT FOR SERVICES RENDERED.

Did you catch the footnote there? Our doctor normally charges $30.00 for labwork, but for our insurance company they’re willing to take $6.97.

This leads to a nasty spiral. If you’re employed in low-wage jobs or unemployed, you can’t afford health insurance. That drives up the cost of your health care, to the point that you start playing Russian Roulette with your ailments. You have to guess whether a given illness is bad enough to warrant going to the doctor. That leads to more health problems, which in turn cost more, and soon you’re circling the drain financially.

Insurance companies aren’t helping. They are notoriously optimized for short-term gains over long-term benefits. They’re public companies, and are driven by market forces that reward immediate cost savings. For instance, my insurance company will not pay for physicals, despite the lower cost of early treatment of diseases and cancers.

Deamonte Driver’s case is illustrative. Look back at the article.

Deamonte’s death and the ultimate cost of his care, which could total more than $250,000, underscore an often-overlooked concern in the debate over universal health coverage: dental care.

$250,000 to care for a condition that could have been solved at the beginning for some $80. In 2004, the uninsured cost an estimated $125 billion. That’s out of $1.9 trillion spent on health care costs overall. Roughly ten percent of health care costs are already spent on the uninsured.

We spend more on health care than any other country. Switzerland insures everyone at a cost of some 11% of GDP. Canada does it for 9.7%. Despite our higher rate of spending, our longevity ranks behind all other industrialized countries.

Even if you’re insured now, there’s no guarantee that a life-threatening illness won’t take all of your money and then some. In 2001, half of all personal bankruptcies were due to illness and medical bills. More than 75% of those driven into bankruptcy by medical issues had health insurance when their illnesses began.

There is an overwhelming financial incentive to fix how we pay for medical care. But for me there’s a strong moral component. Why are we willing to let the poor die from easily-preventable diseases?

Among many of my fellow Christians, there is the idea that the poor deserve what they get. If they are poor, it is because of choices they have made.

“Does God pervert justice? Does the Almighty pervert what is right? When your children sinned against him, he gave them over to the penalty of their sin.”

Job 8:3-4

Those are the words of Bildad the Shuhite to his friend Job. The story of Job is a troubling one. God takes away Job’s family, his wealth, and his health. Job and his friends then argue about why God did this to Job. The safe view of the story is that it explains suffering and pain. It doesn’t, really. You can’t turn to the end of the story and get a pat answer to why, in the words of Harold Kushner, bad things happen to good people.

What we do see is a portrait of how people deal with the problem of suffering. I find Job’s friends’ responses extremely enlightening. Their approach to comforting Job is to tell him to repent. “This is your fault,” they say. “Go back to living a righteous life and all will be well.”

This flies in the face of our experience. Ten-year olds realize that bad people prosper. Good people suffer. “Why do the wicked live on, growing old and increasing in power?” Job cries to his friends. And yet, so many of us cling to the idea that luck and circumstance play no role in people’s situations.

If you’re poor, it’s your fault. And that absolves us of our obligation to help.

“They also will answer, ‘Lord, when did we seen you hungry or thirsty or a stranger or needing clothes or sick or in prison, and did not help you?’

“He will reply, ‘I tell you the truth, whatever you did not do for one of the least of these, you did not do for me.'”

Matthew 26:44-45

I don’t have a solution to the health care crisis. I don’t even know what I personally can do to begin fixing the problem. But that doesn’t mean I should shrug my shoulders and accept the situation as it is. If this is the best we can do for the least of these, then surely we are all damned.

Nostalgia for the 1950s

Here’s something for you to discuss this Monday: in the US, why is our nostalgia overwhelmingly for eras beginning with the 1950s? Commercially I can think of plenty of 1950s-themed restaurants, but almost none from the 1940s or 1930s. When Marty McFly lept back in time, it was to 1955. Even now, fifty years after the fact, high schools still hold dances involving poodle skirts. Granted, they also hold 1960s, 1970s, and 1980s dances, but again, I don’t hear of many events involving flapper dress.

My working theory is that it’s due to television and the standardizing of popular culture. TV went from a rarity in 1950 to near-ubiquity in 1960. While movies provided pop culture that anyone could see, you didn’t see a movie every night. TV thus had a much longer reach. Furthermore, TV shows from that era — Howdy Doody, American Bandstand — can still be seen. You want to know what was on people’s minds in the 1950s? Grab a couple of episodes of The Tonight Show with Steve Allen.

Eli Gets an Early Start

We went to a restaurant for lunch today. Seated near us was a family with three young girls. One of the girls kept glancing over at Eli, who would glance back. “She’s flirting with you,” we told him.

When the family got up to leave, Eli shouted, “Come back! I want to flirt more!”

Belated Baby Update

I went to the doctor on Thursday and all is well with Baby TBA. My blood pressure is good, which in the past has been a concern but it seems when I am pregnant I am in great health. Well, except for the yacking (which is now pretty intermittent, thankfully). I had lost another pound which my doctor thought was fantastic (I am now at my pre-pregnancy weight) and she seems to think that I will drop 20 lbs. with the baby. That would be awesome as far as I’m concerned, but I’m not holding my breath. The baby is much stronger now and is doing less swimming and more outright kicking. While we were in Boston, she actually woke me up one night kicking, so I guess she’s growing.

I’m having a hard time adjusting to the thought of having a girl. I was so sure it’d be another boy that it’s been hard to start thinking in girly terms. I guess ultimately there shouldn’t be any differences. You just love them for the people that they are and gender isn’t an issue. But I have to say I’m a bit miffed that I have to start saving for that wedding. I also have to remind myself that the anxiety that I feel now about who this person will be is exactly the same as what I felt about Eli. I came to love him quite a lot and it will be the same with this girl. I don’t know if my ambivalence is something that a lot of women feel while pregnant and they just don’t talk about it much or if I’m strange. It seems that I must be a least a little bit strange because most women always seem so excited about the prospect of a baby. And I usually am very excited, when it’s someone else. It’s just for myself that I’m not especially thrilled for. But with Eli that changed about two seconds after he got here. So again, I’m sure that will be the case here.

No, we haven’t talked about names much. We are holding onto the girl name we picked when I was pregnant with Eli. I have been calling her that name in my head to see if it fits. However, Eli was going to be Jack right up until I was about 8 1/2 months pregnant and then we changed our minds and chose Eli. But we don’t really have a list. Suggestions are always welcome but no promises that we’ll use your suggestion of Mazie or Zed. Extra points are awarded for names with Zs, Qs, and Xs. I have had Zoe on my mind but since there is now a Sesame Street puppet with that name, I’m less enamored with it.

My mom is visiting this weekend so we’re going to be doing some work on the baby’s room. I guess I should take some pre-baby photos so I can post them and then have some after photos as well. It was such a lovely guest room…

Praise that Causes More Harm than Good

Earlier this week, New York Magazine published an article about how praising your child can damage them.

For a few decades, it’s been noted that a large percentage of all gifted students (those who score in the top 10 percent on aptitude tests) severely underestimate their own abilities. Those afflicted with this lack of perceived competence adopt lower standards for success and expect less of themselves. They underrate the importance of effort, and they overrate how much help they need from a parent.

When parents praise their children’s intelligence, they believe they are providing the solution to this problem. According to a survey conducted by Columbia University, 85 percent of American parents think it’s important to tell their kids that they’re smart. In and around the New York area, according to my own (admittedly nonscientific) poll, the number is more like 100 percent. Everyone does it, habitually. The constant praise is meant to be an angel on the shoulder, ensuring that children do not sell their talents short.

But a growing body of research—and a new study from the trenches of the New York public-school system—strongly suggests it might be the other way around. Giving kids the label of “smart” does not prevent them from underperforming. It might actually be causing it.

In the study, fifth-graders solved a series of puzzles. Half of the students were praised for their intelligence (“You must be smart at this”); the other half were praised for their efforts (“You must have worked really hard.”). Then, for the second round of puzzles, students were offered a choice. They could take an easier series that was like the first series, or they could take a harder series. The students were told that they’d learn a lot from the harder series. The students who were praised for their effort overwhelmingly chose the harder series, while the students who were praised for being smart took the easier route.

I’m reminded of some vocalists I’ve known. Their livelihood depends on a skill that is far from certain. A minor illness or poor choice of beverage can cripple their ability to sing. Anxiety can strip them of their voice. Given the uncertainty and lack of control, some create superstitious explanations about why their voice behaves like it does. In extreme cases they’ll avoid riskier songs for fear of failing. Other types of artists, pro athletes–anyone who depends on uncertain skills can fall into the same trap.

Praising children’s intelligence can push them right into that trap. Intelligence, at least as it’s presented, isn’t something you control, whereas effort is. Intelligence is a gift, after all. What happens if your smarts go away? If you do poorly on a test, does that mean you’re stupid? Best to take the easy way out and avoid failure at all costs. That way people will still think you’re smart.

The problem is that we want to build our kids’ self-esteem. We want them to do well. The tool that’s most at-hand for adjusting their behavior is praise. Given its manipulative behavior, it’s no wonder we all learn to be wary of lavish praise by the time we’re seven. Fortunately, there are good alternatives. Child psychologists talk about descriptive praise, where you describe what your child has done instead of evaluating it. What you’re really wanting to supply is encouragement rather than praise.

This approach to encouragement isn’t limited to how we deal with children. In recent years I’ve taken on a more managerial role in my job. I’ve struggled with how to motivate people and let them know they’re doing well. By nature I tend to let people be. Even if I don’t praise someone, they’ll know they’re doing a good job, right? In fighting that tendency I often over-correct, handing out praise like beads at Mardi Gras, and in the process degrading its effectiveness. What I need is a middle ground, where I hand out praise and encouragement for specific accomplishments.

Maybe I can practice it on Eli first.

Friday Night Videos: A Cappella

Today’s Friday Night Videos is dedicated to Liza.

The Achordants: Such Great Heights (2005)
A college a cappella group covers The Postal Service song, complete with hand gestures and “dancing.” CAUTION: CONTAINS A CAPPELLA SINGING.

The Carleton Singing Knights: Harder, Better, Faster, Stronger (2005)
It’s sad that excited shrieks drown out parts that I expected would be hard to reproduce a cappella. Everyone knows that music should be enjoyed by people sitting quietly in their seats.

Who knew there were so many college a cappella groups covering pop songs with a significant electronica component? Not I, until I started searching YouTube. But it’s not all Daft Punk and The Postal Service. Sometimes it’s Sufjan Stevens. And you know what that means, right? BONUS VIDEO.

The Carleton Singing Knights: Chicago (2006)

And now I am done inflicting a cappella videos on you.

Home is Where There’s Less Snow and More Children

We have returned from our Boston vacation. It started out as a simple idea — hey, let’s run away for a weekend and see some friends and stick the grandparents with the kid! — and grew from there. At one point there were some fourteen or fifteen of us inside Border Cafe in Cambridge talking and eating and undoubtedly disturbing the group of frighteningly bubbly women one table over who kept singing along to the restaurant’s music. We got to see cool art and fish, hear some live music, meet up with a number of old friends, and see others whom we had only met online (hi, Yoon, Joe, and lizard! Hey, Ryan!). It was a great trip, although Boston is far too cold for civilized people. Ice on the streets? Ice that stays around for days? That’s crazy talk.

Thanks to all who made our trip so wonderful, and to my parents for taking care of Eli, even when he developed pink eye.

Friday Night Videos: Robotic 2

There can never be too many robots, which is why I’m repeating this category to bring you:

Beck: Hell Yes (2004)

They’re so cute! They dance! They carry fans! Don’t you want to take them home with you? This video is enough to make you love robots.

The Chemical Brothers: Believe (2005)

If the Beck video makes you love robots, this video will remind you that they are soul-less creatures that will destroy us all given half a chance. I bet those robots are why the man in this video has a cast on his wrist.