How Can WE Fix Our Medical System?

Now that the drama and debate over the legislation is done with, I'd like to try to capitalize on your frustrations. No matter what your point of view in this debate, one thing is clear: no one is satisfied with the outcome. And despite all of the ignorance and spite shown on TV, I think most Americans are more informed and engaged on this issue than they have been in years... which makes this the ideal time for us - individual people - to start doing this the right way: from the Bottom Up.

One of the things that I regretted about the President's approach to health care reform was the way the issue of keeping and managing medical records disappeared from the debate. There are two things that seem to be most broken in our national health care systems: Communication and Liability. Communication needs to be better, both between patients and doctors, and between different doctors (as a patient moves or is referred). Liability means (to me) balancing consumer protection and safety of the patient against protecting doctors from unwarranted lawsuits. (I don't like the term "frivolous".)

I think that we can go a long way toward solving both of these problems by taking control of our own medical records. Keeping good records will mean becoming more involved in our own health; tracking our habits and diets, keeping up on our own regular check-ups, managing our own health histories - all of this will serve to provide our doctors with the information they need, and protect us and them from legal problems down the road. We have online tools for doing this now, which we can access for free and use to interact with all of our different medical professionals.

I've written before about some of the different services, and now I'd like to hear from some of you who have used them. I plan to begin working with my own doctor to figure out which service will work best for both of us, and I will be suggesting to them that they start working with their other patients, too, so that this practice will spread.

We won't clear up the whole problem overnight, but if we all begin taking responsibility for the part that IS within our power, we can begin to influence how the solution will play out. And maybe if we are taking more direct control over our health, the issue of "government takeover" will diminish on its own.

There are four concrete ways this can happen:

1. By using free online services, the cost burden of maintaining records will not be laid on doctors offices, on Health Management organizations, or (as it would eventually land anyway) on the consumer. Services like Google Health (https://health.google.com/health/p/) are going to pay for themselves in much the same way Gmail and the Google Search services pay for themselves (which is a good subject for whole other essay).

2. Since they are free online services, providers and patients will have some flexibility in which one(s) they use. (I suspect that we'll see two or three front runners become the "winners", much the way we've seen Facebook emerge as "the" social networking site.)

3. Privacy has been a huge concern in this, so market pressure will be on these services to give consumers the kind of privacy they need. I see this as an area where the government might need to weigh in, as we (the People) determine what Privacy legally means in this age of widespread information sharing.

4. Health care will improve. When you go to the doctor, they won't have to rely on your memory or their handwriting to tell what your problems are. That alone makes this worth doing.

As I said, I plan on bringing this up with my doctor. I should be having a checkup soon, so I'll report back what I learn from him. If you have any ideas or suggestions, please do comment so I can research them.

Update: In exploring the various online health records services available to me, I discovered that my Insurance provider already has a pretty detailed record of everything I've done under their coverage. They allow me to update this record with tests, procedures, etc. that I might have done outside their system; with my family history; and they interface with the MicroSoft Health Vault, so that if I prefer to manage my records outside of their system (and I know some of you will be concerned about allowing your insurance company to have ALL of that information), I can use that service.

I am a bit embarrassed to discover that this "great idea" of mine was available to me all along, but that probably means that a lot of you could benefit from logging into your insurance company's online service to see what record management services they offer.

My Farewell

I said I would write something. Usually that means words, in some order, meant to evoke something. I guess in this case, it still does, just not in the form I expected.

This is rough, because I wrote and recorded it when I got home from work tonight. Emlyn called at work this afternoon to let me know that Karen passed away in her sleep last night without ever waking up. After 16 years, it is a kind of release for everyone - the kind we dread. It never feels right, whether the one being released is 102 or, like Karen, 37. But in her way, Karen has Always Been Free.

So that's what I wrote.


(For those who may miss it, the words "Always Been Free" are a link to a song.)

Reunions

The Class of 1989/90 Reunion was in February, but I guess I never hit "Publish Post" on this. 'Bout time!

I was pretty surprised that Michelle was willing to drive all the way out to my parents' house to practice our songs for the Reunion. Even in high school - that can't have been 20 years ago already, can it? - we lived pretty far off the beaten path, but after I left for the Air Force, mom and dad bought property even further out, nearly to Wickenburg, and added a good 25 miles to their already lengthy commutes.

But Michelle said she was used to driving all over the Valley of the Sun for her job, and didn't mind. So there we were, playing music and talking about old times and recent times, and about our apprehensions of the Reunion itself. Would we remember the people who showed up? Would they remember us? Fondly? Would our best friends be there, or would they be stuck in far-flung corners of the world?

We needn't have worried.

Even 10 years ago, documenting this would have been more difficult; putting memories down in a blog or sharing pictures on Facebook would have been either unheard of, or at least uncommon. But now, roaming through a hotel ballroom full of not-so-distant strangers is a matter of recognition more than anything; how much do they resemble their profile picture? And can you read their nametag in the dim light? Most of the ice-breaking has already happened online, after all.

So, for me at least, the evening was a stream of people who looked a lot like the parents of the kids I knew in high school, walking around, being happy to see each other. They seemed to enjoy our singing, even though the PA system we had wasn't quite up to the task of filling the room, and they seemed to appreciate our effort.

I'm still not very good at capturing details, of course. I can't tell you who all I talked to - I could try, but I would forget too many names at this point - and I can't tell you who we talked about and caught up on. I can tell you there were a few missing who are no longer with us, and a few I never would have expected to make it this far (and I'm glad you did!), and I can tell you that the overall impression I had was a joyful one.

In a lot of ways, we haven't changed. The patterns of who talked to whom, who got silly-drunk and who withdrew early, the inevitable comparisons of work/hobbies, family, successes and failures; that all stays the same. But because perspectives have shifted, I saw something reassuring in all of it. I saw a truth unfold at my 20 year high school reunion that I barely dared hope would be true all those years ago.

We really are "okay".

Christmas Tracks (aka TrAXE)

Greetings and Happy Holidays to All!

Brent had an idea a few months back. He suggested that we do a Christmas album. He and I and his guitar teacher from Texas, Chase, all thought it was a good idea. We put together some tracks, brainstormed for some silly/cool names, and came up with this:

The Band is "Smells Okay to Me"
The Album is "Christmas TrAXE: A Bag Full of Carols"

And it is up on Last.fm for anyone who wants to take a listen. We arranged them all ourselves, and all but one of them are "Public Domain", so you can download those. (It's all free!)

We hope you like it, and if you do, we'll be putting it out as a CD that you can order (details will follow, in plenty of time for NEXT Christmas).

Merry Christmas!

Christmouse Time is Here Again

So there we sat, two "Br"s and two "T"s, watching Arrested Development, when the dog (one of the "T"s) exploded.

This wasn't the "IED dog harness" type of explosion; this was the "Loony Tunes many-feet blur" type of explosion, and since we haven't clipped her toenails in a while, it took her some time to get enough traction on our hardwood floors to go after... Der Maus.

The mouse made it behind the hutch in the dining room just as I finished a spectacular super-sectional leap. I am not bragging. My leap was made even more spectacular in that I went from a supine position on the swivel chair to full ballet extension, paused the DVD, and landed in the entryway in one smooth movement. The smoothness was only slightly ruined by the Snoopy-dance I did on landing, but since it was less violent than the dog's explosion, and it allowed me to slide gracefully across the dining room in a manner envied by Brian Boitano, I will not feign humility.

Of course, with all of this grace and smoothness, the mouse saw us coming and made a break for the illusion of safety that is the Girl's Room. He dove under their dresser, and I snapped on the light, shouting for the "Br"s to bring me "a shoe or something smashy!" (Both arrived in seconds brandishing goofy looks, and not much else.)

As I excavated old socks, graded homework, karaoke CDs (dang, I could have done "The Middle" at Festivus!), flinging them every which way and barking strategic orders at the others, and trying to get the stupid dog to sniff where the mouse was, NOT the end of my finger. Brent stood in the hallway. "Hey, I see him... he's back behind the hutch!"

So we re-mobilized.

The hutch has a back panel that touches the floor, and Der Maus had foolishly pinned himself back there. If I had had an X-wing fighter, I could have flown it into the little Death Star trench formed by hutch and wall, and blown him away. I blocked my end with a spare cardboard box from the recycle pile, and hollered for backup at the other end, thinking to enact the trash compactor scene instead (still on the Star Wars references for those who are lost). But before one of my storm troopers could get there, Der Maus slipped around the end of the hutch, and disappeared under it.

Now armed with the sneakers of a Texan, the two "Br"s and I arrayed ourselves around the three exposed sides of the hutch. We took turns shouting out nose sightings in a bizarre, non-violent version of whack a mole. We were discussing our next move - something to do with the vacuum cleaner - when he bolted.

He was a scruffy little streak of dark brown. A teen aged girl, a dog, and two grown men chased it the 15 feet from the hutch to the stove without disturbing a single hair on his furry little body.

Once under the stove, Der Maus disappeared. We move the stove, and poked into its many dark crevasses, but to no avail.

Saddened, disheartened, and wretched, we left the dog on guard and went back to the important business we were about before our world was turned upside down.

Vengeance for this humiliation will... be... ours.

Let Me Be Clear

As hard as it is to believe, we are edging into the second year of Barack Obama's first term as President. And just as hard (for some) to believe, the world hasn't ended. But this decade is about to, and I thought I'd get a jump on some of the year end reflection.

About this time 10 years ago, my family was in England, waiting for the world to end because we were told that computers were too stupid to know the date. While it was a relief to wake up on January 1, 2000, and find that we were almost all still alive, some of us were a little disappointed because that meant living through the hangover from the 11 tequila jello-shooters from the night (and morning) before.

About 10 years ago we saw the Supreme Court elect a President who rode to power on a promise to shrink government and usher in an age of prosperity. Slightly less than half of the U.S. population thought this was going to be great, and slightly less than half thought it would be awful. Who knew they'd both be right?

We came home to America only to find that the bubble of prosperity didn't apply to us, and while we tried to find our feet, we witnessed the most horrifying thing to happen to America in my lifetime. It changed us all, causing some of us to turn to religion and some to abandon it; it caused some of us to become more engaged and some to drop out in disgust. But as violent and frightening as it was for everyone, we have managed to pull through. I can't speak for everyone, but I feel like things are finally starting to settle down a bit.

And unlike any that came before (as I have said in other places) last year's election was the first that felt to me like a real choice: a choice between two candidates that I could live with. No one is ever "perfect", but finding even one realistic candidate has never happened to me before, let alone TWO! (Then the GOP nominated Sarah Palin and narrowed the field to one again.)

Since the election of Barack Obama, I have heard a lot of scary predictions from many of my friends about the horrors that would result.

Some feared that "the blacks" would run amok with a black President in charge; they predicted riots and race wars. That didn't happen, unless you count a Supreme Court nominee taking pride in her heritage as a "riot".

Some have proclaimed that our nation is about to become some combination of Socialist, Communist, AND Nationalist under this "radical" Democrat; and they've claimed to represent half the nation in this belief. Neither of those claims are true, unless you count a few thousand angry FOX viewers as "half the nation", and use their bumper sticker daffynitions of 20th Century ideology to guide your personal political analysis.

And best of all, while there haven't been any great, flashy hero moments in the past year, we have (mostly) weathered the economic fallout from the last decade without completely disintegrating... again, as many predicted we would. And I was really worried about that, because so little of our supposed "wealth" from the last decade was built on anything substantial. Housing bubbles, cooked books, "ponzi" schemes... who knew where it would end? But it looks like it will, finally.

There is a lot of work to be done. Nothing is perfect. But from where I sit, we're getting back on track. And I look forward to quarreling, quibbling, and empathizing with all of you over the coming ten years. I hope you'll be there to enjoy it, too.

Lb4Lb#7: Wildflowers Are Petty Things

You probably don't think much about wildflowers. They're really just weeds, after all, and unless they're blooming, they don't have much to offer. But when they bloom...

In 1994, I already knew who Tom Petty was. The Traveling Wilburys and Full Moon Feverhad cemented him in a favored place near my tape deck, and even his Greatest Hitsalbum had impressed me. But I figured the Greatest Hits was an admission that he was done; Mr. Petty had decided to sit back on his laurels and take a well deserved basking.

Fast forward 15 years. I'm in the car with the iPod shuffling through my own greatest hits. I'm almost at the saturation point with most of the 600 or so songs on there. I've heard my recent favorites a million times, and the stuff I haven't heard before isn't making an impression as it floats by. I'm thinking, "It's time to wipe this thing and throw on something different."

Then I hear a simple strumming pattern. It's like the first drops of rain on a dusty windshield, when you're driving over to see your girlfriend at the end of a long week. It's like the first slug of beer after spending the day spreading gravel in Arizona. It's like seeing wildflowers blooming next to a field of scorched, brown grass.

You belong among the wildflowers
You belong in a boat out at sea
Sail away, kill off the hours
You belong somewhere you feel free
- WildflowersPetty has never been the strongest vocalist, or the deepest song-writer. He's not the "rockin-est" rocker, nor is he a very flashy guitarist. He's just that guy you know who breaks out the guitar at parties, and makes everyone feel good. He's that guy that girls don't think about dating because he's "just a good friend", but when they actually give him a chance, he turns out to be genuine and caring.

Wildflowers is built on that vibe. The title track is all about letting someone go where they want, while still hoping that means they'll want to go where you are. There's no pressure, but he lets you know what he wants out of the relationship. He wants to keep it simple, real, and easy.

Doing that, there's always the chance that she'll take you up on the offer and leave, but... why borrow trouble? Why worry that much? You only hurt yourself, after all.

I know your weakness, you've seen my dark side
The end of the rainbow is always a long ride
But don't be afraid anymore
It's only a broken heart
- Only a Broken HeartYeah, he knows the risks. And he's not immune to that urge to control, either. This could have been an album full of passive-aggressive manipulation. Tom certainly knows the temptation.

It's good to be king and have your own world
It helps to make friends, its good to meet girls
A sweet little queen, who can't run away
It's good to be king, whatever it pays
- It's Good to Be KingSo we'll sit back, break out the guitar, and sing together. We'll hang out, and make ourselves easy to be around. Sometimes, you can't be king enough to shape those things that are larger than you, so you have to give in. Be easy. And do what you have to do.

And hey, now baby, what can I do?
What am I goin' to do but trust you?
The rest of my nights, the rest of my days
What can I do but love you?
- House in the WoodsIn 1994, the music scene turned on its head. All of the over-the-top extremes of the 80's metal bands and the effete and introspective self-loathing of the bubbling "alternative" scene collided, and the resulting cloud of ash that we called grunge erupted. It was cathartic, it was redemptive, it was purgative... but it was harsh and unflinching. The music, like the lyrics, explored the dark corners we had all been ignoring, and it changed the way we wrote and heard music.

Everything was about how angry and hurt everyone was. Grunge gave depth to punk, and balls to alternative; it pissed on shallowness of metal, and gave advanced music theory lessons to folk. It was a force of its own, all about denying anyone the opportunity to get close to you, because you knew they just wanted to rip you off.

It affected everything; lyrics, song-writing, form, production, sales, advertising. The flames swept through the music business, and the ashes settled on every genre. No one could sell a record without something "grunge" related - a flannel shirt, a curled fist, an angry riff.

In the midst of all of that, one quiet album pushed something beautiful up through the ashes, and those of us who noticed felt a little lighter for the experience.

Its time to move on, time to get going
What lies ahead I have no way of knowing
But under my feet, baby, grass is growing
Its time to move on, it s time to get going
- Time To Move OnYou don't have to go home, but you can't stay here. Petty knows his limits, and he knows not to expect too much. This makes his album a masterpiece of understatement, as well as an achievement. Not many people can pull off both.

Not many people can craft songs that still bring a smile to your face and joy to your heart when you recognize that simple strumming pattern. Especially not after hearing them for 15 years.