Wednesday, July 24, 2013

The Copay Blues

Many people, when they finally retire, have so many afflictions, requiring pills and potions, and multiple doctors visits, they have to really pinch pennies to even survive. They suffer from the Copay Blues.

Copay Blues

Now that I'm retired
Life has changed a lot,
I can go wherever I want
And get there on the dot,
The outcome of my income
Is a topic oft discussed,
If I spend too much, too quickly
My bank account will bust.

One of the biggest worries
Retired people have,
How to pay for medical care
The Doctors, pills and salve,
You really need insurance
For emergencies and such,
A surgery could bankrupt you
But let's talk about the crutch.

Each time you see the Doctor
For the crutch or pill or potion,
You have to pony up some money
Your hard earned dollars are in motion,
Moving rapidly away from you
For a diminishing return,
Theses are the Copay Blues, my friend
So listen now and learn.

Forget the stupid reasons
When you went to see the Doc,
You had sniffles and a headache
You wanted time off on the clock,
This required a Doctor's note
To get 3 days off or more,
Then they paid you to be sick
Paid time off, now that's a score.

You're not working anymore
The Doctor isn't free,
The crutch, the pills and potions
Could break the bank, you see,
Fixed payments on prescriptions
Percentages till you hit the cap,
And a million dollar hospital bill
Is always there on tap.

Are you worth a million dollars?
That could be more, than you ever earned,
Your Copay would be just a percentage of that
But baby, you'll still feel burned,
Yes, this is a story of retirement
Everything you own, you could lose,
Frittering away your money for medical
Oh, these are the Copay Blues.


A New Disease

Did you hear? Obesity is now a disease. Great news for all of us, right? Now that we got that out of the way, let's go find some other preventable, self-acquired thing, and call it a disease too.

A New Disease

Obesity and smoking
Now called a disease,
Next, I think allergies
Everything that makes us sneeze,
And why not divorce
It can really make you sick,
A thousand rads of radiation
Would get you over it quick.

When we label a disease
The scientists?, how they love it,
Discovering therapy and drugs
And new places to shove it,
Treatments and modalities
Expert opinions abound,
Pharmaceutical designers
Love the dollars, newly found.

Let's say my BMI
Is just below the border,
If I got a little fatter
There's a drug that I could order,
Because, finally I qualify
My insurance says it's so,
It's time for fourteen burgers
To McDonald's I must go

Every problem begs a solution
It's a market driving force,
If you want to win the Belmont
You must own the fastest horse,
We build an industry around it
Find supporters and their money,
Then we'll advertise Obesity
We'll get rich now, won't we honey?



In Michigan, I grew up in a small town, named Lapeer. The hospital there, (controlled by a regional conglomerate) recently decided to stop paying certain Nursing pay differentials. The nurses and the union fought back and won, earning a judgement for back wages. I read about this in the National Nursing press, and wrote the following:


Lapeer RN's
In the town where I was raised,
Hard working patient advocates
Deserve to be praised,
For standing up to management
And their dictator boss,
Now the hospital must pay
Back wages, their loss.

The boss and his board
With their dubious credentials,
Withheld Nurse compensation
Extra paid-differentials,
Without consulting the law
Or communicating their intent,
Now McLaren must pay
Under a shadow of malcontent.

The public and the media
Understand this dirty dealing,
All those hospital billboards
Are no longer so appealing,
And here I sit in California
Reading about my hometown nurses,
In solidarity, we must stand
While clutching our purses.


Thursday, July 11, 2013


Hospital equipment purchasing........who decides what to buy? Who vetted the products? How were they tested, before being bought and placed into use? Shrug; I don't have any idea. I doubt if there is a single department for that, but I think, that at least there ought to be some qualified Mechanical Engineers on staff, to carefully scrutinize machines.

Take our new Auto-flushing toilets with their light-sensor switch. I don't know if it is infrared or just a motion activator, but newsflash, they aren't very reliable. In my careful observations, I'm betting on 50% success. Sometimes they flush, during the deposit, but not afterwards. Or, no flush at all. There is no fall-back handle, just a black, rubbery thing, that looks like a button. But, it isn't labelled, so one has to use a little intuition, to figure it out. I'm thinking of asking the public folks (when I do a "Discharge Phone Call) not only if the Nurses were sweet and friendly, did you get all the education you needed, and, by the way, when you used the bathroom in the hallway, was the toilet bowl flushed and clean when you got there. Odds are, they were too embarrassed to mention, that our public bathrooms often look like a post-apocalypse bathroom in Kathmandu. Quite frankly, that's what I would remember, when I got home. (of course, I'd remember the sexy Nurses too, after all I'm sorta normal).

And the term, "Discharge Phone Call", takes on a whole new meaning!


The automatic
Flushing toilet,
You don't even
Have to oil it,
Greased before
It was put together,
It operates
In any weather.

Sit right down
Or lift the lid,
Do your business
Like they did,
The Engineers
Who took a fling,
Designing this auto-
Flushing thing.

Does it work
After every expulsion?
Or do future users
Face revulsion,
When they discover
Prior remains,
After Billy-Bob
Crapped out his brains.

That's the dilemma
When adopting new tech,
If you believe the hype
From the Salesman, oh, heck,
He was a nice young fellow
Honest and sincere,
With the always-flushing toilet
The hottest thing this year.

These devices never work
As advertised,
Seven times a day
Someone is surprised,
With left-over remnants
From the last user,
Another irate customer
Acting as accuser,
Looking for the perp
Who left his smelly poop,
While the purchaser is to blame
But they're out of the loop.

We nearby nurses
Can't ignore,
So we call Housekeeping
That's their chore,
To clean up toxic
Spills and such,
Though I am betting
They don't like it much.

I suspect
The Hospital Buyer,
Wasn't a thousand
To check if this device
Would really function,
And now we have crap
That needs extreme unction.

Luckily, Sister Euphemia
Hasn't lost her skills,
She knows everything
About flushing pills,
And wadded napkins
Always sanitary,
Though sometimes what's left
In the bowl is really scary.

She says a prayer
And calls, “Oh, Father,
Could you come to
4-East, if it's not a bother,
Because we need an Exorcist
To straighten out this mess”,
Sister Euphemia snickers
Knowing she might have to confess,
That she's overwhelmed
With this toilet disaster,
And she's merely dumping it
On the local Headmaster.

Didn't these new toilet flushers
Arrive with the latest C-E-O?
Is there some correlation
Underneath it all, that might show,
Where this organization is heading
Down the tubes, and such,
There's no way to say for sure
But we don't like it too much.


Big as a Barge

Three hundred eighty pounds fella, with new-onset Atrial Fib. Unsure how long he's had it, as his Left-atrium is enlarged, and his ejection fraction is only 40%. He thought the arrhythmia was due to stress at work..........a salesman / broker for multiple Nurseries. He did admit, that he and his wife, do love to eat (she's 200 pounds plus, herself). He was shocked (cardioverted) twice, and got back into Sinus Rhythm. He'll take some meds for a few months and see if he stays in rhythm. I'm betting he doesn't diet, but I'm the perpetual cynic, aren't I?

Big as a Barge

A BMI of forty-eight
Admit it now, that's too much weight,
To carry around on your skeletal frame
Regardless if you're a guy or a dame.

It's really such a case of denial
A thousand excuses in your personal file,
Categorically, ignoring the fact
You are obese, don't call it an act.

It's bad for your family
When you're as big as a barge,
If your kids eat like you
They too, will get large,
Adult-onset Diabetes?
There's a childhood rendition,
Thanks Mom and Dad
For promoting this condition.

Your sleep is disturbed
Because you snore all night long,
Fat throat, heavy tongue
Makes the apnea song,
Like a snorting Bull Moose
With his mating call of Spring,
A slew of comorbidities
Is the song you will sing.

Insulin resistance
And Atrial Fib,
Yeast infection colonies
Where you once had a rib,
At the seventeenth fat roll
Down south near your gut,
And you can't even speculate
What happened to your butt.

From the front, you're a bulldozer
From the back, a Mack Truck,
At a distance you're a blimp
And in the doorway you're stuck,
But once you were a baby
No more than 12 pounds,
Now you're three times my size
Which is out way of bounds.

So, today we shocked your heart
From A. Fib to Sinus,
But I guarantee it won't stick
Until your weight becomes a minus,
And your cardiomyopathy
Will only worsen, unless you change,
Curtail your gluttonous eating
Or drop dead on the driving range.


Bits & Pieces

In my lifetime, I have been acquainted with three people who later committed suicide. I get it, they had pain, but they didn't have a clue regarding how much pain and suffering they were leaving to their supporters and loved ones. Usually that suicider made a lot of people miserable, even before they took the easy way out. So I don't have much sympathy for your suicidal are narcissistic and grossly self-centered. Grow up or give up, but please do it quickly, Ok?

Bits & Pieces

Artists and musicians, and
Other people who made the choice,
To exit on their own terms
Maybe even crashing the Rolls-Royce,
Although, that's not usually the vehicle
More like a gun or a bridge;
But, not too many people
Lock themselves in a Fridge,
Airtight and cold
Or positively freezing,
Nor do they wrestle with an Octopus
For the ultimate squeezing.

The bystanders, stand by
What else can they do?
They can't put your brain back together
With Dollar-Store super-glue,
No, what they're left with
Are bits and pieces of your pain,
And perhaps, it's just as well
That you ventilated your brain.

Because, we all, were very tired
With that pity-party crap,
It might have worked in the beginning
When you dropped it in our lap,
But time, brought understanding
And distance showed us truth,
Your misery was founded
Way back in your youth,
Before we ever met you
Some bad luggage you've carried forever,
And in our loving relationship
You chose to use it as a lever.

So, goodbye to you
Thanks for picking up that gun,
Or you jumped off that bridge
Or dived into the Sun,
Whatever it was
You did us all a favor,
And finally, dear friend
You chose the right flavor.


Wednesday, July 03, 2013

No Coming Back

There was well-known person (celebrity) in the news recently, who made a very personal and difficult healthcare decision. This woman chose to have an elective breast removal (and reconstruction) because she carries (in her family), a genetic pre-disposition for Breast Cancer (reported to be as high as an 85% probability). Persons facing this dilemma, certainly have a daunting “possible future” of Cancer. I am not diminishing their experience by asking the big question of probability: If I might risk dying from a disease, that I know I have a greater than 75% chance of acquiring...........would I choose to remove the organ now?


No Coming Back

If my mom and dad had a brain cancer
Should I remove my brain?,
If I remove my nervous system
Could I eliminate my pain,
If my left leg has cancer
Should I lop off the right?
If I remove both of my kidneys
I won't have to pee at night.

Removing healthy organs
Seems drastic to me,
It was hard enough to grow them
And they certainly weren't free.

Described in magazines and TV,
Do a lot of crazy things
Unlike you and me,
Would you lop off your eyeballs
Just because there was a threat?
You would never see the world again
Children, beautiful flowers or a favorite pet.

Most of us have hearts
Guaranteed to disease,
If we manage to live too long.......
“So, Doctor, I ask you, please,
I want to eliminate the possibility
Of any chance of heart attack”,
Hopefully, my Doctor says, “No, Bobby
You're going down a road, where there is no coming back”