Thursday, August 27, 2009

Health Care Plan For Doctors




There are geriatric programs now that encourage medical students to spend 10 days or so in a nursing home -- as patients. They are given a "pretend" disease and diagnosis, and if that means living in a wheelchair and eating a special diet, that's what they do. One student who was at a VA hospital, smeared petroleum jelly on his glasses and put cotton in his ears to replicate a patient with failing eyesight and hearing. I think this is a great idea and will give these men and women more empathy for their patients once they become doctors. But I don't think it goes far enough, and I believe all doctors should learn what it's like to be a patient in their specialty before they get a license to put on their white coats and ask us to take off our clothes.

Obstetricians should have to have some sort of uncomfortable pillow bulging from their stomachs. Then they should be subjected to perfect strangers touching their bellies and saying things like, "In my day, the doctors didn't let us gain so much weight." Of course, the male future obstetricians will get some different kinds of comments, but they must just smile at the skeptic who doesn't believe a man can get pregnant.

Pediatricians should have to go through everything that babies endure. Their cheeks should be pinched, and people they don't know should pat their bottoms affectionately. When the male students' diapers are changed, they can't say a word when whoever's changing them makes a comment about the size of their genitals. On the other hand, since they will be pretending to be babies, the students will be allowed to try to pee on the person changing their diaper.

Those prospective doctors who plan on treating adolescents will have huge false pimples placed all over their bodies. Then in the waiting room, they'll have to sit next to young people with perfect skin who look at them with disgust. When they see the doctor, they'll sit there calmly as he tells them, "They're just pimples. Nothing to worry about. Nobody will even notice."

Medical students pretending to be adult patients will have to wait up to two hours before seeing their "doctor." Then after he or she deigns to see the student, the doctor will have the wrong file, take personal calls, and forget why the patient is there. After that, the medical student/patient will be presented with a bill whose total will be slightly more than the Gross National Product of Brazil.

Getting back to the geriatric patients, as I said, I think it's a good idea, but it's just a start. Those posing as senior citizens should be ignored by people in the gift shop, pushed out of the way by younger people, and spoken to by almost everyone in a condescending tone of voice.

To give the prospective doctors an even greater idea of the frame of mind of some seniors, they should have to participate in a little play. The students should be seated at the kitchen table while those pretending to be their kids are off to the side. The kids talk about the senior citizen as if he or she isn't there. They don't even bother to whisper. It would go something like this:

DAUGHTER: "We've got to do something about Dad."

SON: "What are you talking about? He's fine."

DAUGHTER: "He's not fine. Just look at him."

At this point, the son and daughter look at the medical student/older person who continues to eat his or her breakfast cereal. The son and daughter shake their heads glumly, and the student is supposed to act as if he doesn't know they are talking about and staring at him or her.

SON: "Well, he can't live with us. We don't have the room."

DAUGHTER: "I knew you were going to say that. Okay, he can stay with us, but I get Mom's jewelry."

At this point, the medical student/senior has the right to pretend to be choking, and to spit the cereal all over the kitchen table.

I definitely think this kind of program will make doctors more compassionate towards older patients. And it might make them think a little longer about how much they should leave their kids in their wills.




Thursday, August 20, 2009

Government Wants To Dine With You




The public debate over health care has become increasingly contentious. There is a group of people that doesn't want the government to be involved in anything having to do with their health. They seem to conveniently forget about Medicare, but that's their right. I recently learned that there is a proposed provision in the health care bill called The Affordable Health Choices Act. This has to do with insisting that restaurants put on their menus caloric and other nutritional information about the food they serve. Why haven't I seen crazed people (some with their precious legal guns), screaming their opposition to the government telling them what to eat? I'm surprised I haven't seen angry signs, saying things like, "I'll be Unhealthy If I Want To," or "Feds: Keep Your Hands Off My Fat."

The proposal is not as simple as one would hope. As of now, the bill only applies to chains with twenty or more restaurants. These restaurants must post calories on their menus and provide other information such as fat and sodium content if customers request it. Small restaurants claim the new menus would cause too much of a hardship for them. Needless to say, the chain restaurants don't think this is fair. So we have the weird situation in which Domino's Pizza, Del Taco, and Jack in the Box, among similar places, are calling for a plan that would give more nutritional information to more people. This is like the tobacco companies saying, "No, those warnings on the packs aren't scary enough. Let's just say these things cause cancer, and you'd be a fool to smoke them."

Let's assume that they work out the details and come up with a menu labeling bill that makes sense to all of the restaurant owners. If it helps people lose weight and avoid things like diabetes and obesity – which is the purpose– I think it's a great idea. There's nothing wrong with educating people about food.

But I'm concerned about how this is going to change the American dining experience.

Let's say you and your spouse go out to dinner for your anniversary. You go to that special, favorite restaurant of yours. Do you really want to see how many calories are in that item that you've dreamt of for weeks? Will the two of you have a good time if, after the waiter describes a delicious dinner, you stop him and ask, "How many grams of sodium are in it?" Will you skip that special dessert if you see that it contains more calories than a marathon runner burns? Will the two of you end up just ordering salads, and then uttering those words that have become part of our modern vocabulary – "and I'd like the dressing on the side, please."

This may take some of the fun and all of the romance out of eating. Maybe the restaurants should print up two sets of menus: one for those who want the information and one for those who don't. Of course, it's quite possible that those who don't want to know how many calories are in the Chocolate Surprise are those who need this information the most.

Maybe they should add an "every once in a while clause." This would entitle us to go out to dinner every once in a while, and order from old-fashioned menus without the nutritional information. This would apply to holidays, birthdays, and anniversaries. And I guess it should apply to days when you're feeling really good. Of course, you might also want to enjoy food when you're feeling really bad. And then there's... Okay, okay, maybe the "every once in a while clause" isn't such a practical idea.

Obviously, when I think about the statistics about how unhealthy we eat and what the costs are both in terms of health and money, I'm for this plan. These harsh realities outweigh my concerns about fun no longer being part of eating.

But I am concerned that this kind of thing can get out of hand. Food regulations are a greasy slope. This bill may lead to people ordering without even mentioning the food, and just saying things like: "I'll have the 13.28 grams of fat, 453 milligrams of sodium, and 28 grams of carbohydrates." If we ever get to that point, I'll rebel and work to repeal the bill. Or at least, I'll ask for a side order of 39 grams of sugar.






Friday, August 14, 2009

The Porn Business Is Sagging






Like many businesses, porn has fallen on hard times. Sales of sexy DVDs have dropped drastically, and the porn producers aren't making it up on the internet. Big porn actresses – most of whom seem to be named Savanna or Savannah – are being paid less to have more sex. Before you jokingly suggest that the government bail out smut, "Hustler's" Larry Flynt was way ahead of you. He and "Girls Gone Wild's" Joe Francis said they were going to ask Congress for $5 billion back in January. Of course, Flynt's motives were purely altruistic. He said, "With all this economic misery and people losing all that money,... it's time for Congress to rejuvenate the sexual appetite of America. The only way they can do this is by supporting the adult industry and doing it quickly."

So far, Congress has not responded to the suggestion. In one way, that's surprising. Over and over again, in scandal after scandal, we've seen how important sex is to our Senators and Representatives. Maybe they'd vote for a porn bailout if they could use a phony name, like when they check into a motel with someone they're not supposed to be with. If they voted on it by secret ballot, it would probably pass faster than you can say, "I'm the new delivery boy. Are you home alone, Mrs. Jones?"

Considering that we get so many spam emails about porn, how could the porn industry be losing its shirt... and pants? Almost every day, I'm invited, courtesy of the internet, to watch videos of men and women doing things that I never even thought were possible. It turns out that porn is not a recession proof business. It makes sense that some fans of the genre have decided that their money should go elsewhere these days, even if the videos are shot in High Definition.

And ironically, the internet, that porn-filled swamp, is killing the professional porn industry. People can see all kinds of porn on the internet for free. Much of the sex on the net is allegedly pirated from "legitimate" porn companies. Other offerings are videos that people take of themselves or their friends and then put them on the web. I'm not sure who these people are or why they don't worry about what their grandparents – or grandchildren – will think, but there is no shortage of folks who are willing to have video sex. Even if these home videos are not of professional quality, the porn companies can't compete with those who are giving it away for free.

There's also a theory that in recent years, the American attention span has shrunk. We are used to short snippets, rather than long stories. Steven Hirsh, co-chairman of Vivid Entertainment says, "On the internet, the average attention span is three to five minutes," not an hour and a half. Even though porn was never known for its compelling storylines, people don't seem to want to have any story with their porn anymore. They just want the sex scenes. In a recent article in the "New York Times," sex actress Savanna Samson commented on this development, "I used to have dialogue," the frustrated thespian bemoaned. (Or maybe she moaned).

She's not the only porn star who is hurting these days (and not from leather whips). In a recent story in the "Los Angeles Times," Savannah Stern (see? Another Savannah) said she has had to replace her Mercedes with a used Chevy Trailblazer. She got the Trailblazer from her parents. It's nice to see them being supportive of their daughter's career choice, isn't it?

So is this the end of porn? Don't bet on it. Porn has been in the vanguard of technology before. Now the sex industry is talking about putting its product on mobile devices. Great -- as if people aren't staring at their IPhones and Blackberrys enough. The theory is that mobile devices are more personal, more intimate than regular computers. People would be able to take them anywhere they want to view porn. But is there actually an audience who will pay to watch adult movies on those itsy-bitsy screens? I guess we'll finally find out if size really doesn't matter.





Thursday, August 6, 2009

Will "Clunkers" Save The Economy?





Even those who thought it up were surprised by how successful the "Cash for Clunkers" program was. Not me. I knew it would be huge. This wasn't because I thought it would be so easy for people to take advantage of it. In fact, it wasn't. There are rules. For example, the "clunker" has to have at least 80,000 miles on it. Some people probably drove their cars around the block over and over again to try to get the mileage up (I'm still 39,206 miles short). But I'm sure they were in the minority. The reason I was so certain that it would be a success is because it's just so American.

Americans like new things. We're not like people in other countries who boast that they live in a building that's hundreds of years old. Americans brag that they live in the newest house on the block. We look down upon older things. Notice that the program was not named, "Cash for Classics Cars." In music, an "oldie" might have been recorded in the 90's. Ballplayers are traded when they become "old" – like when they're thirty. So I knew that Americans would jump at the chance if a program helped them get something new.

Because of the positive response of the program, it wasn't surprising that the House of Representatives quickly passed a bill to extend it. And politics being politics, it wasn't surprising that the Senate balked at the extension despite the country's enthusiasm for it.

Of course, not everyone in the House was for it. Texas' Jeb Hensarling mocked it, saying, "Maybe we should have a ‘Cash for Cluckers’ program and pay people to eat chicken." Since I like chicken, I wouldn't necessarily be against that idea. On the other hand, I'd oppose "Cash for Brussels sprouts."

I understand what the witty Congressman was saying. In this program, we taxpayers are basically giving money to people to buy cars. For some reason, that doesn't bother me. I'm a lot happier with this deal than with our giving money to the people who helped our economy collapse. Congressman Hensarling opposed those earlier bailouts, too, but I guess he didn't make the national news since he didn't come up with a "clever" slogan as he did this time. I guess he just couldn't think of "Bucks for Brokers."

I like "Cash for Clunkers." It has put new, fuel-efficient cars on the streets, and infused the economy with much-needed money. It hasn't only helped the car industry and related businesses. People who work at car dealerships shop just like everybody else. So that woman who bought a new Chevy last week might be responsible for the guy across the country selling more fancy dog food. When future students study this phenomenon in college, it might be known as the Camaro-Kibble Effect.

Equally importantly, "Cash for Clunkers" has been a positive symbol. It says to America, "Hey, some programs actually work. Maybe we really can get out of this recession." And there's got to be the feeling that if the ailing auto industry can be helped, there's bound to be hope for Joe's Hardware store.

It's a big opportunity for the American auto industry. More than half of the cars purchased under this plan have been American makes. If these shiny new fuel-efficient cars turn out to be great, more people will buy them even without the "Cash for Clunkers" program. Of course, if they turn out to be junk in a year or so, the industry will be hurt even more, and those who bought these cars will feel that all they got was a newer clunker.

But if the economic experts do all their analyses of "Cash for Clunkers" and come up with positive results, watch for copycat programs. The big one will be "Cash for Firetraps." If people want to get rid of their old, falling-apart houses and buy new ones, the government would help them out. The housing industry won't say "no" to that idea.

Yes, "Cash for Clunkers" tapped into the very American love of getting rid of the old and acquiring the new. I just hope that its success won't make people go overboard. If so, I'm really in danger of my wife trading in her clunker of a husband for a new model. And believe me, I've got more than 80,000 miles on my odometer.





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