We Are Amazed and Grateful

Last night was the first time in eight days that Merrie had no breathing assistance during the night. She also has not had any oxygen assistance since this morning, and she is doing well.

The angiogram involved a catheter in her femoral vein, which was kept in for 24 hours as a precaution. This has meant that she’s had to lay still for 24 hours. She’s quite weak, but feeling much better, perhaps because the blood flow to her heart is so much improved. She is looking forward to some walking tomorrow.

The attending doctor said that her status will be upgraded soon from ICU care, and we may move to a new hospital room if one becomes available. While there’s something to be said for the privacy and attention of the ICU room, we are relieved beyond words that the doctor is so encouraged by her progress.

Medication will be part of Merrie’s life for some time to come, especially a powerful blood thinner that prevents clots forming around the stents. The cardiologist is recommending that we wait awhile before considering surgery, which would be high risk due to some radiation damage to Merrie’s heart. We are blessed that, aside from the leaky mitral valve, her heart seems now to be strong and efficient.

And the end is in sight. At least a temporary end. The doctors actually mentioned that Merrie may go home in a few days.

Amazing. Truly. We are thankful for your support, love, thoughts and prayers.

I guess I’m feeling better, too. Maybe tomorrow, in addition to a Merrie update, I’ll write about why the stock market went down. I’m annoyed that the real reason has not been mentioned. At least I haven’t heard it.

Change of Venue

I spent this morning at home, and was putting clothes in the dryer when I heard the phone ring. The pets scattered in panic as I dashed inside, only to find the handset missing. Quick, to the other phone. That handset was missing too. Where were the handsets? I found one, picked it up.

“Hello?” Dial tone. Oh, well. If it’s important they’ll call back. It wasn’t because they didn’t.

An hour later my cell phone rang, and when I answered it, Merrie’s voice was on the other end. The angiogram was finished. It had gone fine, and three stents had been put in. She was going to spend the afternoon in the Coronary Care Unit at Scripps, and then be taken back to Kaiser.

This has now been a bi-hospital experience, and may wind up as a tri-hospital experience. There’s a possibility that eventual heart surgery will be performed in Los Angeles.

The doctors are monitoring Merrie’s condition and we’ll see where we go now.

Whistle While You Walk

When I arrived at Merrie’s room this morning, she was in her lounge chair and about to walk, assisted, to the bathroom, for the first time in more than a week. Then, after a rest, the nurse took her on a short walk around the nurse’s station.

As she was walking, Merrie said she felt like she should either sing or hug all the nurses. (They could probably use a hug. They have a rough job.) I gotta say I felt like singing myself. But if I did that, alarms would be going off all over the ICU.

Tomorrow is a crucial and pivotal day. Merrie will be taken to Scripps Hospital in La Jolla for an all-day procedure. Then we’ll have a clearer idea what the treatment options and risks are.

Merrie is still quite weak, and we both know we face some hard choices and a long recovery. There surely will be bad days and some rough sledding ahead. But we have enjoyed today, and we are thankful for that.

Thanks to everyone who has sent their good wishes to us. It means more than we can say. Your generous thoughts and prayers make a difference.

Remember that flowers are not allowed in the ICU, and I am home very little (which means the only ones enjoying the flowers will be the cats, and they like how flowers taste, not how they look). If you have sent flowers, rest assured they have not gone to waste. We pass them along to other patients, many of whom have no one to send them flowers.

A Bit of Oscar-Watching

Things are looking better today. Merrie had a good night’s sleep, and ate about half her breakfast. We had a pleasant moment basking in San Diego State’s defeat of BYU yesterday.

It’s a relief to be sitting in the ICU and not have any alarms going off. Peaceful rest is a very good thing right now.

After breakfast the nurse helped Merrie move into the reclining chair. It was the first time Merrie stood up in the last six days. She has spent most of the day in the chair, alternately attentive and asleep during some college basketball and the endless arrival of stars on the Oscar red carpet.

She’s still wearing the breathing mask most of the time, but thanks to an adjustment in her medications, she is not dealing with the huge breathing problem she faced yesterday.

Though she is weak and we know we face a long road ahead, today has been a good day. We have received many cards and e-mails with prayers and good wishes, and we are grateful.

Some Days Are Better Than Others

A visitor--who has spent much time in the hospital himself--told me yesterday to expect a cha-cha. Two steps forward, one step back.

There have been some struggles today. Merrie’s body is having a hard time readjusting to real food. More important, breathing has been hard.

As I write this, she’s trying to rest with a breathing mask on her face. Things are not made easier (for us, anyway) by five different kinds of alarms going off incessantly--in our room, and in neighboring rooms.

I have learned to love the welcome sound of a soft click, as a vital sign improves enough to stop the alarm.

And so today we struggle for hope in the midst of a wait laced with anxiety.

No More Ventilator

This morning Merrie began breathing completely on her own again. The ventilator tube was removed, and so was the feeding tube. What a relief.

She’s been doing some breathing exercises and has been sitting up all day. All vital signs have been stable, and she has moved from ice chips to water to a liquid diet. This evening we are watching "Jurassic Park 3."

It has been mentioned that we may move out of ICU in the next couple of days, but that is unofficial (translation: from the nurses). The cardiologist said we likely will be traveling to Scripps Hospital next week for an angiogram, to check the condition of the blood vessels feeding the heart.

So today we are grateful for some new signs of hope.

Waking and Sitting Up

I just witnessed the ICU bed slowly change into a chair. Merrie is sitting for a while after being on her back for two days. Her sedation is being decreased, and the ventilator is on assist as she begins to breathe on her own.

She has been communicating today by writing notes, and they have been coming fast. She started by suggesting that she keep a chart of how she breathes each hour, and that I keep one, too--because “I may make mistakes.” It’s good to see her coming back to her regular self.

We’ve been catching up a bit. We’ve been reading cards and e-mails together. The photo of Sophie from yesterday’s entry is hanging from the TV set.

We don’t know what will happen tomorrow, but today has been good.

ICU: San Diego

Merrie has been in the hospital since Valentine’s Day with what appeared to be pneumonia. The good news today is that all tests for infection in Merrie’s lungs have been negative. She does not have pneumonia.

Merrie had Hodgkin’s Lymphoma in 1991, and a recurrence in 1995, with rounds of chemotherapy and radiation in her chest area. It turns out that her current condition is a direct result of consequent damage to her heart, lungs, lymph and blood vessels feeding the heart.

Her heart’s mitral valve is weakened, causing some backflow of blood into the heart and lungs. This has been going on for some time, and has caused her shortness of breath, and the pressure in her chest that precipitated our trip to the emergency room a week ago. It also caused the pulmonary failure and cardiac arrest which began her stay in intensive care yesterday.

She will have an angiogram soon to try to get more-specific information about damage to the blood vessels and the heart.

What we are looking at now is trying to help her get stronger over the next few days so that her mitral valve can be replaced. Her vital signs seem slightly better than yesterday, and she wakes up from time to time and tries to communicate. Her sedation is being reduced today, and she will be fed a bit through her feeding tube.

And so we wait and hope. We are very blessed to be receiving excellent care, and to have loving and supportive friends and family.

The Lost Week

I’ve always liked the title of the film “The Lost Weekend.” Ray Milland starred as a man who loses a weekend to an alcohol-induced blackout. That’s not exactly what has happened to Merrie and me, but “The Lost Week” would be an appropriate name for our last seven days.

I took Merrie to the emergency room on Valentine’s Day when she had pressure in her chest and shortness of breath. We were relieved that there was no initial indication of heart problems, though it seemed she had an unusual form of pneumonia.

Several days passed, with numerous tests and procedures done, many medications administered and several complications endured. Her breathing was very labored through all this, but it seemed to me that she was gradually becoming more comfortable. Maybe even the end was in sight.

But it isn’t. This morning her breathing stopped and she went into cardiac arrest. We are blessed that this happened in the hospital, because the team of doctors revived her and took her to the intensive care unit.

That’s where we are, at the end of this “Lost Week.” Merrie is on a respirator, heavily sedated and totally monitored. As we wait to see what happens next.

Martha Washington, Hollywood and Teachers

Quotes of the day:

“So the Christians and the Pagans sat together at the table,
finding faith and common ground, the best that they were able.”
--Dar Williams

“[It’s a] dreary industrial town controlled by hoodlums of enormous wealth, the ethical sense of a pack of jackals, and a taste so degraded that it befouled everything it touched.”
--S.J. Perelman, talking about Hollywood.

“Some southern California students have been secretly videoing classroom moments and putting them up on YouTube. One clip, in which a teacher at Malibu High School loses control of his class and raises his voice while students laugh, has sparked a debate that led to the district’s cutting access to YouTube on school computers and limiting electronic devices on campus.”
--Tami Abdollah and Amanda Covarrubias, LA Times, February 9.

“I am still determined to be cheerful and happy, in whatever situation I may be; for I have also learned from experience that the greater part of our happiness or misery depends upon our dispositions, and not upon our circumstances.”
--Martha Washington (1732 - 1802)

There is No Blame

Quote of the day:
“Sometimes you sense how faithfully your life is delivered, even though you can’t remember the address.”
--Thomas R. Smith

Quote of the day no. 2:
“Sometimes I stand in the grocery checkout line and look at all the pretty faces on all the magazines and I think, why don’t we have a magazine titled People Who Matter?
--Carol B. Wilson

More on "'24' is a Brutal Comic":
Number of people U.S. counterterrorism agent Jack Bauer personally killed last season on the TV show 24: 38
--Harper’s Index

Number of incidences of torture on prime-time network TV shows from 2002 to 2005: 624
Number on shows the previous seven years: 110
--Parents Television Council (Los Angeles)



Quote of the day no. 3:
“There is no blame; there is only love.”
--Ann Karasinski, in an excellent "This I Believe" essay on NPR’s "Morning Edition."

Every normal parent on the planet wants to protect their children. Protection is a natural, expected and vital part of parenthood. Parents want to protect their children from whatever might harm them, including questionable friends and tawdry and corrosive influences.

But (and you knew a but was coming) no matter how complete or careful the parental protection, bad things still happen to children. And when these bad things happen, parents often drive themselves crazy trying to figure out what they could have done differently.

It is very hard to accept that, ultimately, we cannot control whether our children have pain or trouble in their lives. We can influence a bit, but we cannot control.

I strongly commend Ana Karasinski’s very poignant NPR essay to you (go to NPR.com). Especially if, in spite of all your efforts, your child has pain in his or her life.

How We Can Leave Iraq

Quote of the day:
“I was gratified to be able to answer promptly. I said I don’t know.”
--Mark Twain

Ocean fact of the day:
Factor by which the average noise level underwater has increased since 1965: 3.
--Harper’s Index

Most of the news coverage about Iraq is yes/no. Should we withdraw or not? Should we increase troop levels or not? It’s easy to forget how complex the situation is, and that American interests are just one part of a long equation.

New York Times columnist Thomas Friedman addressed some of the complexities last week:

“Right now everyone in Iraq is having their cake and eating it--at our expense. We have to change that.

“The Sunnis, who started this whole murderous cycle, participate in the government, negotiate with us and also indulge the suicide bombers and the insurgents.

“The Shiites collaborate with us, run their own retaliatory death squads and dabble with Iran.

“The Saudis tell us we can’t leave, but their mosques and charities funnel Sunni suicide bombers to Iraq and dollars to insurgents.

“Iran pushes its Iraqi Shiite allies to grab more power, while helping others kill U.S. troops. Ditto Syria.”

Then Friedman proposes this solution:

“OK, boys, party’s over: we’re leaving by December 1. From now on, everyone pays retail for their politics. We will no longer play host to a war where we’re everyone’s protector and target.

“If you Sunnis want to go on resisting, we’ll leave you to the tender mercies of the Shiites, who vastly outnumber you. You Shiites, if you want to run Iraq without compromising with Sunnis, fine, but you’ll have to fight them alone and then risk having to live under the thumb of Iran.

“You Saudis and other Arabs, if you don’t use your influence to delegitimize Sunni suicide bombers and press Iraq’s Sunnis to cut a deal, we won’t protect you from the consequences.

“And Iran, you win--yes, if we leave, you win the right to try to manage Iraq’s Shiites. Have a nice day.”

You Betcha I'm Entitled!

Quote of the day (humbly from myself):
“[An Inconvenient Truth] puts to rest for good the idea that the climate changes scientists have been noticing for years are just part of a natural cycle that the earth has seen before.”
--From I’d like to Thank the Academy

Most unexpected Valentine’s quote of the day:
“Marriage in America is to love as laxatives are to constipation. Something that makes everything flow much easier.”
--Jolynn Hope Brooks

Thanks to Barbara (not her real name) for today’s “guest annoyance”:

“I get really sick of hearing Social Security and Medicare referred to as ‘entitlements’ that have to reined in. If by entitlement they mean a benefit that I'm ‘entitled’ to because I've been paying into it for my entire adult life, fine.

“If, however, they mean a social welfare program that I ‘feel entitled’ to because I'm just a suck on society, that makes me mad. When the government automatically deducts money from my paycheck and requires me to send them a percentage of my self-employment earnings for these programs, I think the government and I have a contract together.

“So there.”

Anna Nicole Smith, or Peace in Palestine?

Quote of the day:
“It’s not meant to be funny. It just is.”
--Last line of theme song to the Anna Nicole Smith TV show.

Quote of the day no. 2:
“[T]here was something appealing about Anna Nicole, too. She was a survivor—you don’t make it from Jim’s Krispy Fried Chicken to Hollywood semi-stardom without working every angle you can find. She may have married poor J. Howard Marshall for his money. After all, she did kiss him on the cheek after they exchanged wedding vows, then left immediately for a modeling job in Greece.

“But she knew what she wanted, and she got it—and he seemed perfectly happy during the 13-month marriage, which ended in his death at age 90. You could sense how desperately she craved fame, how much she wanted to leave behind poor, uneducated Vickie Lynn Hogan (her given name) and morph into something fabulous. And she did. Who cares if her version of fabulous was trashy.”
--”Why We Liked Anna Nicole Smith,” from February 8th Newsweek online.

Quote of the day no. 3:
“Rival Palestinian factions Fatah and Hamas have signed a deal to form a national unity government.”
--BBC Online’s lead story, February 8th.

Initially I was sanctimoniously aghast at the death of Anna Nicole Smith dominating news coverage, pushing “real” news down the food chain. Surely, anything about an agreement between rival Middle East factions is more important.

Yet the Anna Nicole Smith story is in the lead. It is the story that most interests and fascinates us.

I am now much calmer. The above item from Newsweek is onto something. Her story was at least a bit more than an empty celebrity tragedy. Smith came from a poor background and made no bones about exploiting her looks or anything else to achieve success.

She wasn’t nuanced or subtle about it. What she was doing was abundantly clear at every turn, whether it was constructive or destructive to her, and however we may have felt about her actions.

This makes her pursuit of the American Dream a much, much more interesting story than that of the typical celebrity. And certainly in a different league than the incessant chattering about the silver-spooned, attention-seeking, talent-challenged Paris Hilton and her ilk.

What an annoying ilk.

"Little Children" and "Notes on a Scandal"

Quote of the day:
“What did you learn in school today? Did you learn how to believe or did you learn how to think?”
--Ralph Nader’s memory of what his father told him as a child.

We’ll be hearing more in coming days about the movies “Notes on a Scandal” and “Little Children.” Actresses from both films are nominated for Academy awards. And though the films are quite different, they have a significant theme in common.

Judi Dench is especially memorable in “Notes,” portraying an aging and sexually frustrated schoolteacher attracted to a vulnerable married colleague, played by Cate Blanchett, who is also nominated.

Kate Winslett is nominated with Dench for Best Actress (which is the toughest category this year--all the performances are great). In Todd Fields’ “Little Children” she plays a suburban housewife who begins to sense something is missing in her life. She finds herself attracted to a househusband who hangs out at the same neighborhood park she does.

Interwoven with this story is that of a convicted child molester living in Winslett’s neighborhood, and the wave of fear and anger his presence elicits. Inappropriate sexual contact with a minor is also a major element in “Notes on a Scandal.”

From these capsule descriptions, these films may not sound all that appealing. Yet they are both excellent, courageous, moving and thought-provoking.

In very different ways they deal with the human need for intimate connection, and what happens over time when that need is not met. There is a wonderful, wide variety of human beings sensitively and realistically portrayed. Each person is a bit flawed in different ways, and each is struggling in his or her own way for connection.

"Rapture": Reality or Song by Blondie?

Quote of the day:
“Remember that you’re just an extra in everyone else’s play.”
--Franklin Delano Roosevelt

Questionable assertion of the day:
Former evangelical leader Ted Haggard, who left his position last November after it was revealed that he had regularly visited a gay prostitute, now declares that he is “completely heterosexual.”

“Apocalypse Not” was the name of a conference of religious leaders held recently at Trinity Church in New York. "Christian Century" magazine recently ran a brief item about it.

The conference was organized as a response to concerns about the coming end of the world from two different groups--conservative Christians who believe there will be a “rapture” and those concerned that the environment will soon degrade to the point that life on earth will cease.

About the latter concern, theologian Jurgen Moltmann reminded attendees that “life on earth” includes much more than human life. As such, it is virtually impossible for all life to be wiped out any time over the next two or three billion years. Moltmann used the example of life on earth continuing after dinosaurs became extinct.

Belief in “rapture” is widespread these days. The popularity of the best-selling "Left Behind" series of fiction books is evidence of this. Underlying most religious beliefs are inherent personality and emotional traits, which give power to the beliefs. Generally, people who believe in a coming literal apocalypse are unhappy in their current circumstances and want to look forward to the day they will be freed from them. This is a broad simplification, of course, but when you look across the groups who teach this belief, you will find it to be mostly true.

Theologians, scientists and religious people can debate the reality and timing of the end of the world. Liberal and conservative biblical scholars can argue about whether Revelation is a literal prediction of the end of the world, or an allegory about hope in the presence of corruption and the abuse of power.

But I’m a practical guy. Instead of spending time panicking or praying about the end of the world, why don’t we simply do something now to make life around us a little better?

A Logjam of Woes

My apologies for the late posts. The dog ate them. The real story is that my iBook had to visit the Apple doctor for a couple days. All is much better now.

Quote of the day:
“He is a Sunni, born in Jordan, but his wife is Shiite, so he likes to tell people that he is ‘Sushi.’”
--Raffi Khatchadourian, referring to Haitham Bundakji, in the January 22nd New Yorker.

Video of the day:
Caffeine Does Your Body Good, click here.

When was the last time you used any of the following words in daily conversation: “woes,” “logjam” or “kingpin”?

These are not common words in our daily lives, yet we see them every day online, on TV and radio news, and in newspapers.

“Woes” is an excellent example of a headline word. It doesn’t take up much space, so it is easy to fit into a headline. So we read about budget “woes” as opposed to overruns, shortfalls, disagreements, misunderstandings or problems.

The use of “logjam” is more mystifying. Is there a significant beaver component in the news audience? Seriously, there’s nothing wrong with the word (or any of these words), but must we use “logjam” every time we mean “impasse”?

My favorite is “kingpin,” which was likely originated by reporters covering bowling. It has a slightly sinister air, and is often used in connection with criminals. For example, “drug kingpin.”

This word suffers from too narrow a usage. When are we going to hear about the hamburger “kingpin” or the crabcake “kingpin,” or the chocolate-chip cookie “kingpin”? Who is the laundry “kingpin” at your house?

How Do Our Leaders Get Things Done?

Quote of the day:
“If in the last few years you haven’t discarded a major opinion or acquired a new one, check your pulse. You may be dead.”
--Gelett Burgess

Quote of the day no. 2:
“We like so much to hear people talk of us and our motives, that we are charmed even when they abuse us.”
--Marie de Sevigne

Quote of the day no. 3:
“I said, ‘Now is when we have a chance here, and you want to have it all perfect. It won’t happen. You’re not the majority.’ I said, ‘When does that get into your mind? You’re not the majority.’”
--California Governor Arnold Schwarzenegger, in a private conversation recorded in March 2006. He was referring to his fellow Republicans in the legislature.

This quote comes from CNN. The governor also compared his experience as a child in post-World War II Austria to plans to build a fence along the Mexican border:

“We had the Berlin Wall; we had walls everywhere. But we always looked at the wall as kind of like the outside of the wall is the enemy. Are we looking at Mexico as the enemy? No, it’s not. These are our trading partners.”

Reason Has Left the Room

Trend prediction quote of the day:
“We’re just on the cusp of a massive explosion in mobile Internet and computing and adoption taking off.”
--Michael Cahill, Portfolio Manager, Chilton Investment Company

The earth is at the center of the universe, with the sun and stars revolving around it. Diseases are caused by demon possession. Or they are caused by an imbalance of bodily humours. The four known elements are earth, air, wind and fire. The earth was created 6,000 years ago.

All of these ancient beliefs, common at the time of the bible, have been superseded by uncontested scientific discovery and research. But, according to a 2006 Gallup poll, almost half of Americans still believe that the earth was created 6,000 years ago, literally according to the account in Genesis.

There is a creation science museum just outside San Diego, and a “Creation Museum” under construction in Petersberg, Kentucky, near Cincinnati. The San Diego museum is a popular stop for groups of schoolchildren who visit from Christian schools. Among the exhibits is a row of photos of “creation scientists” across from a row of photos of those “believing” in evolution.

The row of photos of those “believing” in evolution includes Karl Marx and Adolf Hitler, but does not include other “believers” such as Abraham Lincoln, Martin Luther King, Albert Einstein, Ronald Reagan, John F. Kennedy, Desmond Tutu and Gandhi.

My guess is that the belief in biblical creation will very gradually decline over the next 100 years, but it will hang on beyond all attempts at reason--as it has over the last 150 years. When Copernicus demonstrated that the earth was revolving around the sun, it was considered just a theory. Years later, Galileo, whose thinking now underlies much of modern science, faced persecution and excommunication from the church when he presented data confirming Copernicus.

It took hundreds of years for a majority of people to accept that the earth revolved around the sun. Evidently, it will also take hundreds of years for a majority of Americans to accept that the actual age of the earth is 4.5 billion years.

Style, Fashion, Trends and Fads

India statistic of the day:
Number of parliament members: 545
Number who have been indicted: 100
--Edward Luce, from In Spite of the Gods: The Rise of Modern India.

Quote of the day:
“I have been a clinician for over 30 years, and a researcher, and I think spanking, by and large, is an adult temper tantrum. I’ve never quite understood how you’re going to help your children manage their impulses by losing control of yours.”
--Kyle Pruett, a clinical professor of psychiatry at the Yale University Child Study Center. He was responding to California Assemblywoman Sally Lieber’s bill to prohibit spanking of children under age 4.

Quote of the day no. 2:
“We all develop our personal styles by noticing what people like about us, and exaggerating it.”
--Peter Schjeldahl in the January 29th "New Yorker."

Style, fashion, trends and fads. Each of these terms has a distinct meaning, yet we often confuse them or squash two or three of them together to make a point.

Each of us has a style, whether it’s appealing or unappealing. As Schjeldahl says, we find something about ourselves that gets a rise out of people, and we do more of that, or wear more of that, and it becomes a personal style. If we proclaim we have no personal style, that proclamation describes the non-style that is our style.

Fashion is an attempt to group similar styles into common categories and put a label on it and maybe sell into it. Clothing fashion designers are especially sensitive to what people like, or probably will like, and they create clothing according to these likes.

A trend is a repeating event or behavior over some significant period of time. True trends in just about anything are fascinating to study. But the caveat here is that real trends are very hard to spot. We love to pronounce trends on the basis of our enthusiasm over one or two things we have seen, and these pronouncements can be very entertaining. But they are rarely accurate. Indeed, even experts usually get trends very wrong. See my post "Trend, We Hardly Knew Ye."

A fad is something that there is some excitement about, and it appears quickly and disappears just as quickly. Examples of fads: the Macarena, Aunt Mabel as a day trader, gatoring, buying and flipping the house next door, disco, $15 pomegranate martinis, having lots of tattoos, painting each room a different bright color, saying “far out,” carrying a mouse-sized dog in your purse, “Who Wants to Be a Millionaire,” “Deal or No Deal,” and 15 different TV series about forensics.

Many times we jump into fads in a search for belonging or excitement, or in an attempt to make a lot of money (see the near-daily full page newspaper ads proclaiming “how I make $20,000 a month in my eBay business, and you can, too!”).

Fads come and go, but style goes on and on. Some great things today were great 50 years ago and will be great 50 years from now. Knowing what these things are makes life delicious.

How We Ration Doctor Visits

Quote of the day:
“Television news is like a lightning flash. It makes a loud noise, lights up everything around it, leaves everything else in darkness and then is suddenly gone.”
--Hodding Carter

India statistic of the day:
Expected population in 2050: 1.6 billion (surpassing China).
--Edward Luce, from "In Spite of the Gods: The Rise of Modern India."

More on Health Insurance and Iraq:
“By not taxing employer-paid insurance, the government now provides a huge invisible subsidy to workers. [Bush’s proposal] would not end the subsidy, but by modifying it with specific deductions for insurance, he would force most workers to see the costs.”
--Robert J Samuelson, in the January 29th Newsweek.

Samuelson makes an important point. Most of us who have health insurance may know only what our premiums are, what our copayments are, and what the limits of our coverage are. We don’t know the real cost of the care we receive.

The health care debate is all about costs. It’s all about money. For years, proposals for any kind of government-sponsored health care were derided as systems for “rationing” doctor visits. Critics pointed to inefficiencies and problems in systems such as Canada’s, suggesting that the last thing we needed was “rationing.”

Another Newsweek columnist, Anna Quindlen, made an excellent observation about this a few years ago. She pointed out that we already “ration” health care, but the rationing is invisible because it is based on money. Those who have money get health care, those who don’t do not, or are enormously inconvenienced.

To make good decisions about how to provide healthcare coverage to those who most need it, it is vital that we understand what the costs are. Then we can decide the best way to pay these costs.