Monthly Archives: November 2009

Tuesday the 17th

Today I got frustrated at the little kids, except you can’t call them that anymore when they’re taller than you. They were just loud, all afternoon, and acting—literally, acting—stupid. Pantomime, exaggerated faces, pre-arranged catch phrases, stereotypical tones of voices–you never saw people trying so hard to pretend that they had, say, 10 IQ points. Curly, Larry and Moe looked clever in comparison. Meaner and more unpleasant, yes, but certainly more intelligent.

I told them to stop being so loud and stupid. They insisted they were no louder or stupider than normal. I hid.

Being goofy I understand. Pretending to be so vacant minded you don’t know how to keep the drool inside your mouth, I do not. I am suspecting the biggest draw is that annoys the eyebrows off your older sister.

This is the time of year where one learns the true meaning of love. No, it has nothing to do with the holidays, religious or otherwise. It has to do with the fact that true love still loves even when it’s getting its eyebrows annoyed off. Love still loves when someone is being too touchy, and being grouchy when everyone is still acting “normal”. Being crowded in the house with a bunch of other people coupled with a disturbing lack of sunlight means that you either start killing people or beginning to grasp what was meant when it was said “Love bears long.”

Unfortunately, like most reminders of what is truly important in life, these reminders are not entirely comfortable. I just hope that—if I’m going to be reminded regularly anyway—I’m learning from these reminders. No chastening seems pleasant for the moment, but afterward it yields good fruit, and all that.

Monday the 16th

Today I woke up and remembered a dream, which for me is unusual. My dreams usually fall into 4 categories. (1) Barely remember I had them, and only if I try hard can dredge up some bits of them. (2) Remember them, but were clearly a rehash of something I was thinking about right before I went to sleep. (3) Have seemingly no connection to anything and are absurdly random and shifting, yet still able to mostly remember, and (4) Strangely crystal clear with nearly every detail intact–and sometimes quite lengthy at that.

Categories 1 and 3 are what I normally have (though remembering any semblance of a dream is unusual for me). 4 is extremely rare. This was a category 3 dream, which means random and shifting.

It started out that I was up in our woods singing hymns with a bunch of girls I didn’t know. Apparently, this was not the first time we’d done this. Apparently, it was becoming a rather regular thing for me to go up into our woods with a bunch of stranger-girls and sing hymns. Not all of the songs were ones that I recognized, but I was learning and generally having a good time, even though it was apparent I was not, erhem, the lead singer of the group. It was fall.

Then we were done and went back down to the house. There “someone” (unclear/unnamed) was telling me about “someone” (a vague acquaintance, a friend of a friend–in other words, also “unnamed” or a non-entity) who had just given birth after a very troubled pregnancy, which she had kept secret from everyone else. The troubled part, not the pregnancy part. Apparently, the baby had almost died about 4 times during pregnancy, and there had been a lot of emergency intervention. But she had refused to let it get her down or give up, and had basically kept the entire fiasco under-wraps, rather than spread around a very anxious drama. Only now that the baby was born–underweight, but seemingly healthy–was she actually talking about the grave danger the baby had been in the entire time.

Then the dream morph-shifted, and suddenly it wasn’t a baby of a friend of a friend of a friend, but was much more familial. It was unclear if the baby was a child of one of my siblings or sibling in its own right, or what, but it was definitely one of the family. It was hanging out with us, and shrieking and laughing with much vigor and good cheer–which was splendid, considering how many times it (or she, rather) had come to dying. More concerning was the fact that, though she had several teeth (top and bottom) and was old enough to laugh and shriek, she was still only about the size of a newborn–quite underweight!

In the end, though, her apparent good cheer and our delight and love for her seemed be outweighing the concern at her obviously troubled weight. When I woke up, those feelings of contentment and welcome for another little family member was all that remained. Fully waking up caused me to be a little disappointed it was only a dream.

The end. Y’all are free to psychoanalyze in the comments. (I know that certain people would anyway, so I figured I might as well get ahead of the game and call it open season.)

Friday the 13th

Today our physics professor threw our planned quiz in the recycling bin. Before he had us take it. Because he likes us. Pretty much. No, really!

See, the quiz was technically scheduled for Wednesday. But Tuesday evening, the school discovered a gas leak, and the entire campus was closed to staff and students for all of Wednesday. He didn’t want to push if forward any further or we couldn’t get it back before the exam to see how we did. But when he was scheduling the quiz, we had all asked him to please not put it on Friday, because we already had one (and some of us two) tests that day already.

So he ditched the quiz. He said he didn’t want to pile any more stress on us in one day. We didn’t have to take it. Which was nice, because it looked like the nastiest quiz he’s handed out yet (he let us see it). It was quite the relief.

We started out the day with our bio exam for lecture, which are always stressful. It was a little easier than the last one he gave, so I think most of us did well.

Then we went to physics, where our quiz was canceled. Then he said threatening things about peoples’ homework being either exceptionally good or exceptionally. . .not, with no in between, and started returning them. I was in the clear—it’s really only his quizzes that mess me up. He calls them “conceptual”, which means, don’t work any think out, just remember all the nouns and labels. Figuring out I can do. Remembering the proper terminology I don’t do so well at.

Then a bunch of us got together to warm-up for our bio lab quiz, which was on muscles. I think we were all particularly nervous about that one–not because we expected it to be hard (on the contrary, there was a lot of overlap with our PTA muscle class), but because our pride was on the line. He knows which ones of us are PTA student, and this would be just the most perfectly ironic time for us all to majorly flub it.

I dun’t think we did.

We’ll get our scores next week.

If I wasn’t going to college, I probably would have written this on my blog anyway.

I can’t call it polished and brilliant, but an honest assessment of it says it sounds like something I would have written on my blog–with all that that implies–before I subjected myself to things like word limits and writing regularly. (I call it, “I banged it out without going back and editing it at all, and somebody more brilliant than me will probably blow it full of holes.) So, anyhow. Without further ado, and all that:

There Ain’t No Such Thing As a Free Lunch

There ain’t no such thing as a free lunch. That was the first thing I learned in highschool economics. Lunches do not just materialize out of nothing. Someone, somewhere paid for that lunch. Another thing we learned was that money does not magically multiply when it passes hands, particularly not when it goes to Washington and back. And finally, we were implored to understand the whole supply-and-demand cycle.

These three facts were the cornerstones for understanding any deeper thought of economics. They were basic; they were fundamental. “If you can’t remember anything else from this class, please remember this!!”

Being the younger sister of a true economics geek, I felt rather abashed that, yes, that was really most of what I could take away from the course, besides a vague awareness of some of the mechanisms of economy. I felt like I had an embarrassing lack of knowledge of economics.

Today, I struggle with a different problem. Today I struggle with the fact that most do not seem to grasp any of these foundations, and, in fact, greatly dispute them.

I am thinking, in particular, of health care. Health care is indeed exceptionally expensive; I have no issues with that. What confounds me is the commonly voiced thought that “health care costs need to be reformed.” Oh ho. All that has gone wrong is people charging too much, ay? We just have to straighten everyone out, and then we’ll have affordable healthcare, is that it?

I struggle with this attitude, because as far as I can tell, it violates every single last one of the foundations of economics.

We are getting ready to study reimbursement for health care services we provide, and the whole situation seems absurd. No longer is there a simple straight forward contract between provider an patient—both are enslaved to the managed care companies. The insurance companies tell the provider what services they can charge for, and how much, and how long. The insurance companies tell the patient who they will allow them to visit, how often they can visit, what services the insurance company will approve.

It is absurdness. The whole point of insurance was supposed to be peace of mind—peace of mind for the provider, that they would be paid for their work, even if the patient was unable to pay themselves. And peace of mind, too, for the patient, that they would have the care they needed even if they couldn’t pay. Instead, it becomes a cruel tug-of-war. The patient is afraid the insurance company will deny payment. The provider spends ever increasing amounts of time trying to meet the insurance companies’ demands for requirements for reimbursement—time that neither the patient nor the insurance company will pay them for. The insurance companies short the providers, deciding they won’t pay what the provider needs to maintain their business. The insurance companies short the patients, saying they have to pick up the rest of the bill and pay large co-pays.

So, then, is it all the insurance companies’ fault? The private insurance companies follow the lead of Medicare and Medicaid. Ah, so, it’s all the governments fault then!

Is it?

It is a very sorry cruel fact that there is no such thing as a free lunch. Like other laws of nature—gravity, freezing temperatures, bodies unable to survive without food. There seems to be a strain of thought that says, “if it’s nasty, we should get rid of it. We can get rid of it!” But we can’t get rid of gravity, and we can’t make something for nothing.

Surely we agree health care needs to be paid for. There are people working every day, sometimes for terribly long hours, to provide health care. They should be paid, yes? Of course! But where does the money come from to pay them? Someone, somewhere has to pay for it.

Let’s see. The patient? Wait. They don’t have enough money. They need help. Perhaps we shall start an insurance company; they will pay what the patient cannot.

And here is our first hiccup. Money does not magically multiply by changing hands. The patients send in their monthly dues to the insurance company, but it simply isn’t enough to cover all the bills. Perhaps part of this is due to the fact that the insurance company needs some of that money to cover its own costs—afterall, insurance employees work, too, right? Somebody has to do all that paperwork. It takes time. They deserve to be paid. So not only does the money not only magically multiply, it actually shrinks. And there isn’t enough to go around. So, the insurance company looks to cut costs. Part of that is done by trying to limit what the providers can charge, but part of it passed back to the patient in the form of higher dues, higher co-pays and less coverage.

Wait. Now insurance is more expensive for the patient. They can’t afford insurance. They need help. I know—the employers can help pay for the insurance!

But where does the employer get this money? They have overhead. They aren’t an endless well of wealth. To get this money to help pay for insurance, they will have to cut something else out. Perhaps they will fire employees; paying less employees will me mean money freed up for insurance costs. Maybe they will play the employees less. So who is getting shorted?

Whoops, there is still no free lunch.

Well, there is always the government. They can assist us.

But where does the government get its revenue from? Whoops, again. The taxpayers. Does the money multiply, to take it away from the taxpayers so you can give it back to the taxpayers? Sadly, no. In fact, the money shrinks some, because, after all, government employees deserved to be paid too, right? They work all day too, right?

No matter where we look or how hard we try, we just can’t make healthcare cheap. We can shift around the cost, we can shift the blame. But we can’t make the money grow.

Well, if we can’t make the money grow, we need to make the costs shrink. Right?

How? Everything and everyone needs to be paid.

But surely there is a creative way to cut costs. Surely there is waste that can be trimmed. There is of course, the absurdity of a third party to decide what counts as waste—not the provider, who is familiar with the problems and treatments; not the patient who is dealing with the problems. But the third party payer!

More than that, though, there is still that same issue of there being no free lunch. You cannot turn lead into gold; you cannot turn a sow’s ear into a silk purse. After a certain point, there is simply a limited number of resources, and you must make difficult choices. This has often been succinctly stated by saying “Quality, Speed, Cost: Pick Two.”

Pick two? Everyone wants all three! But the frustrating fact is that if you make quality and low cost a paramount, speed will be shorted. There will be longer lines, there will be limit to how much can be provided. Quality and speed, then. Well, now your costs will be sky-rocketing. In order to get professionals who will work well and work quickly, you will have to pay them exceptionally well. The main reason people are gravitating toward health care is the lure of good pay. Take that away, and no one will bother to learn. (This is the cruel concept of supply and demand. If something becomes rare, you must pay more for it. If the market is flooded, you can pay less.) Cost and speed? Quality goes down.

We cannot avoid this. No more than we can all decide to walk on the ceiling instead of the floor, we cannot make high quality, good speed and supply, and low cost all co-exist at the same time. What we have presented before us is not a question of how can we make desirable properties of speed, quality and cost all co-exist at once. The question is, what are we willing to give up, and what is important to retain? And who gets to decide?

Would you like someone else to decide for you which part will cut back upon? Or not? If one doesn’t want someone else to decide, one must take responsibility. If provider billed patient and patient billed insurance company, there would be accountability. If the provider violated the values of the patient (for instance, was fast and cheap but did not provide quality care), the patient could “punish” the provider by switching providers. If the patient billed the insurance company for the reimbursements they’ve been paying monthly for and the insurance company denied it—the patient could hold them accountable by switching insurance companies.

But that takes time and personal responsibility. It will be work; it will be yucky. For sure. And many people don’t want to deal with that. They want it to be someone else’s responsibility. They have been allowing the insurance company to take responsibility, but you know what? That’s been kind of yucky, too. It really hasn’t been working out so well. So we could hand the responsibility over to the government. Guess what? That’s going to be yucky, too. The government can’t fix it any more than it can give its citizens the power to walk on the ceiling.

We can shift the blame. We can shift the responsibility. We can shift where we are shorted—from cost to quality of care to easy access and back to cost again. But we—not us, not employers, not insurance companies, not the government—cannot make the problem go away. All we can do is look at the choices and decide which we find more acceptable.

And that is essentially the debate that is going on now. Should we give the responsibility to the government, or keep it to ourselves? Do we want the government to decide if we will have quality care or quick care or affordable care? Or is that choice we want to reserve to ourselves, as a personal decision? And some people feel that they don’t care if you want the government to decide for you, but they don’t want the government to decide for them. This puts the government in the bind of how you can decide for some people, but not others—and who gets to decide who the government gets to decide for?

But it’s rather silly to call it health care reform. It may change—of course it will change! But you can’t “fix it” so that it is cheap, effective and available for all—not the government, not the insurance companies, not the employers, and not the providers. Because there is no such thing as free lunch–something, somewhere, must be paying for it somehow. The only question is, what are we willing to pay, and what kind of lunch do we want?

Thursday the 12th

Today I flustered my English teacher.

You see, with our current arrangement, I write all during class on my laptop. Then I email it to her at the end of the class. Last Friday I started writing something I couldn’t do even a passing resemblance of justice to in 45 minutes, so I called it part one of two. Monday I wrote part two. Today we had our consult. She’d gotten a bit behind, and apologized she hadn’t gotten a chance to read it yet, and so read it while I sat there.

Long end short of it, she was embarrassed and uncomfortable because she was not “prepared to teach at this high of a level” and “hadn’t put together a class suitable” for me and felt like she wasn’t earning her paycheck. She reiterated she was confused as to why I had been made to take the course. She liked my “style” (freed from the constraints of assignments, my normal mode of writing is surfacing). According to her, the writing was polished, the argument was sound and persuasive, and if we could have “discussed literature–oh, the fun we would have together then!!”

*cough*cough* Erm. . .let’s just say I don’t quite share the sentiment.

In fact, I am just about counting days until I can be done with my “liberal” portion of my education–at the very least, for this semester. (I have to take psychology 2 next semester and a second writing course over the summer.) I don’t think I could ever bear to go for a full-fledged liberal arts degree. Yes, I know there are varying qualities of teachers out there, but it’s all hogwash–and rather ripe hogwash at that. A person can develop cancer from being around that stuff too much, you know. It just isn’t healthy.

Full disclaimer–both my parents and a brother of mine have liberal arts degrees. I don’t know how they survived.

Wednesday the 11th

Today I was thinking about methods of homeschooling. I was spurred on by reading a fictional account of a one-room schoolhouse, thinking about how the process of education has changed over the years. Of course, I also considered my own schooling, and where I’m at now. Here’s three things I would (hypothetically) do differently:

(1) Do more in the way of reading aloud/recitation. I never got this as a “subject” when I was younger. It sounded like a complete waste of time. Now, I find myself struggling (in small ways) with my speech. I talk too fast; I run words together. Reading aloud is hard, because my eyes keep skipping ahead and I don’t clearly articulate (or fully read) the words. You never get too old to be read aloud to, and you always need to be able to talk coherently. At the time, it seemed pointless. Now I wish I’d put more practice into it. Old habits are hard to break.

(2) Do more in the way of verbal drilling. Again, when I was younger, I was against this. Who wants to run through the multiplication table out-loud? Do addition and subtraction aloud? Yeah, well, just wait till people start asking you to do math in your head, without pen or paper. They ask you a question, and instantly your mind blanks. Practice with not loosing-grade school arithmetic as soon as someone asks you a question would probably be a good thing.

Verbal drills also includes spelling. All the good spellers I know say they just “see” the word and then spell it. I’m familiar with “looking” for a visual thought of something I should know, but when you only write words, they seem to be saved more as a familiar hand motion or a general idea of something. Actually saying every letter in the correct order would probably help.

(3) Ditch all formalized science and social study books. Honestly, they never teach you much of anything, and there is no better way to make you dread a subject. I can see such formalized books as useful in giving teachers a bit of a subject guide, but science and social studies are two areas I think you can learn better from natural curiosity and interest. Certainly the majority of history that I actually remember came in the form of historical fiction I just wanted to read or tangential research from something I wanted to look up–and same goes for science.

Tuesday the 10th

Today I was supposed to study diligently all day.

That didn’t happen, of course.

Well, I did get a fair amount of studying done, but I did a fair amount of not studying too. One of the things I did was re-read my blog from when we started this challenge. I discovered several things.

(1) I do an awful job of staying even remotely near the word limit.

(2) My writing seemed to be at it’s best when I knew what I wanted to say before I sat down to write and I stayed within the word limit. (There wasn’t very many posts like this!) Those posts were also the most satisfying and difficult to write. Every word had to be measured carefully, but you could tell that every word counted when you read the final post.

(3) It was interesting to watch things progress. Often times, when writing, I would be frustrated that it seemed I was always talking about the same things. In retrospect, it was interesting to watch things develop.

As far as gaining the discipline to write every weeknight evening, the challenge has been quite successful. In terms of actually improving my writing. I’ve got a lot more discipline learning to go. Unfortunately, the reason why most of my posts wandered was because I didn’t actually have anything to say, which kind of breaks the first rule of writing–don’t speak up if you have nothing to say. But it only “kind of” breaks the rule, because, as with anything else, you improve with practice. Someone (it’s disputed who) is credited with saying all authors have a million words of junk they need to get out of their systems. At my current rate, inflated beyond the challenge though it is, it will still be quite some time before I reach a million!

Monday the 9th

Yesterday I went to work, came home, took one of those dumb intelligence tests (the point was to do better than my brother, which I believe I succeeded in), cut 4 heads of hair, called a friend I hadn’t been in touch with for a while, ate too much supper, studied more in preparation of tutoring muscle class, and lectured myself thoroughly about trusting God (which I’ve heard before, but, you know. . .I tend to need reminding).

Most of those things aren’t related; some are. A PTA has to work under the supervision of a PT, and the PT I worked with yesterday is a PT I’d want to work under. . .but the cynical part of me kicks in, and says even if I got hired by them, they’d pair me up with someone else. Or I won’t get hired by them. Or, hey, who’s to say I’ll get hired by anyone? That’s when the lecture kicked in, because, you know, God knew what, if any, PT I’d be working in before I ever started going to school to be a PTA. In fact, He knew before I was born. In fact, He’s the one calling the shots about the whole deal, not me, not any PT in existence, and not any establishment. It’s good to know. but hard to remember.

I’m sure that I’ll go horribly over word-limit to discuss why I like working with her, but I feel like talking about–so here goes.

We are similar enough, yet different enough. We can understand each other, but help each other out. She always strikes me as just a little bit borderline ADD–doesn’t like to be bored, doesn’t like to do repetitive things or paper work, likes to goof around—but, when inspired, can really put her nose to grindstone and be incredibly productive.

And I like all of that. I tend to take myself too seriously, but it’s boring to work around people who take themselves too seriously, and it makes me feel homesick. Plus, around those who don’t take themselves too seriously, I remember to knock of my seriousness myself. For her part, I keep her on her toes–in a good way. It’s more fun to be on top of your game when you know someone will always notice when you are–and when you’re not. It’s not quite sibling rivalry–but it’s bordering on it.

But a big part of it, I think, is that I don’t feel like I have to explain myself so much. I don’t feel so much like no matter how many words I use, I will never be understood. Not that we have innate perfect understanding, but that she can pick up, understand, and account for various parts of my personality–and will pick on me for it–without me having to say anything about it. Any PT will tell me what time they start so I know when to get there. She’s the only one who would ever even think to tack on “PS Don’t panic if its 7:35, I know you are OCD so think of it as 7:30 ish!”, and laugh at me, knowing full well that by 7:29 I’d be checking my watch. (Note: she arrived at 7:33. And laughed at me because I was checking my watch.)

These things are the things that are hard to find.

Friday the 6th

Today I got an email from the Rehab aide that often/usually works upstairs (in-patients) on the weekends. It basically said “Oops, I agreed to work this Sunday but I can’t. Can you work it instead?” It’s nice that I can still work some hours even while attending school, but as a person who likes to plan and schedule, it’s always frustrating to have it dropped on you at the last minute.

This week I amused myself by weighing my knapsack. It was 26.5 lbs on Monday and 29.5 lbs on Thursday. My biggest distress is not how heavy it is, nor how cumbersome it is, nor that I have to lean forward to counterbalance–the only real distress is that it looks like one of the seams for the shoulder strap is threatening to undo itself. Not nice, especially on such a new, expensive knapsack.

My oldest brother was pretty confused, though, as to why I would think anything less than 40 lbs would count as a heavy knapsack. To further my amusement, I did a quick search on “how much weight does a marine carry”. The entirely reliable Yahoo! Answers (tongue in cheek) says that when they are first starting you out in boot camp, you carry maybe 15-20 lbs at a leisurely pace and not too far. But by the end of it, expect a 50-60 lb sack, plus full “battle rattle” and a quick pace for 15 miles. But, in real life, expect an 80-90 lb pack, plus a bunch of other junk.

A marine I am not.

But I do get some weird looks on campus for carrying around 1/5 my body weight on my back. Especially since I’m so short.

Thursday the 5th

Today someone wanted to know how old I was. I don’t remember what he said (he’s married with two teen-aged daughters, so don’t get yourselves too carried away, please), . . .oh, wait, yes I do remember how it went. He was talking about the last time his favored sports team won–a whole decade ago, in 1999. So I said, man oh man, I can’t believe 1999 was 10 years ago. Now I feel old! Down right ancient!

So then he was like, yeah, you would have been pretty young, right? I mean, how old are you? —or something along those lines. So I told him the same thing I tell everyone.

“You have to guess first. That’s the rule. I’ll tell you how old I am, but first you have to guess.” Sometimes I throw in extra lines about “no, really, I won’t be offended” or some such thing. He wiffled and waffled, but in the end his curiosity won out.

“18,” he blurted, “if that.”

“Nope, I’m 24.” Off by a whole 6 years. I suppose he thought I had been eight when I was really 14.

No one thinks I look as old as I am. He at least had a guess that maybe–just maybe–since I was homeschooled, I quit highschool early to come to college. Nope, that’s my brother out in the lobby on his second year of engineering–he’s 18 and quit highschool early to go to college. Someone else thought my brother an I looked the same age. . .but no one at all thinks I’m anywhere near 24.

Which, just so you know, makes me feel like a very brilliant and mature 18 year old. Much nicer than feeling like a typical 24 year old. At 18, besides looking like I was 12 or something, I don’t think I was anywhere half so good at faking it when I didn’t have a clue. Now I can “exude confidence” better. . .even when I’m saying “I have no idea at all.” Now I am confidently clueless. It’s a real step up!