$180,955.40

That’s the FIRST Charge we have seen from my wife’s lumbar laminectomy http://www.spine-health.com/treatment/back-surgery/lumbar-laminectomy-open-decompression.

I suppose I should start by saying that it has now been a month since the surgery and she is walking and doing normal little things that we all take for granted until we have to have someone else do them for us. i. e. dressing, bathing, primping, light household functions like folding clothes, taking the dog for a short yard walk. The prognosis is very good, 70% improvement in the spinal column. We are thankful & hopeful for the procedure at this juncture. It is too soon to tell yet about the level of recurring pain but we are hopeful now, whereas before there was no longer hope of a pain free life.

I look at the bill, which is just the hospital bill, not the surgeons nor the anesthesiologist, nor other specialist that will pop up along the way and I wonder exactly what it means in terms of who gets what. Medicare has paid $19,969.83, we have paid $283.00  and our insurance has been billed. This bill shows a patient balance of $817.00 but of course no one pays the first bill until the insurance company pays what they pay and there’s a bit more time to figure out exactly what we absolutely have to pay. I’m betting it isn’t much more than we have paid because that’s what the doctors and hospital told us when we very pointedly asked for numbers.

So what really happens to the “adjustment” of $158,168.28? Is that a total write off or how does the hospital recover anything and what portion do they recover? What are the true costs of the hospital and how is their billing regulated and validated? Are there standards and measures that hospitals and Doctors are required to follow? Does our newly created health care reform deal with any or all of these issues? Do the politicians who have prostituted their votes for reform know the answers to these questions or are they only concerned with anecdotal sound bites that helped sway the emotions of their electorate?

See, when we talk about healthcare there is so much that is not understood by so many it is clear that most of us don’t have a clue how the system really works, so intelligent argument is almost an oxymoron. I know my wife and I paid for Medicare for decades and also made intelligent and judicious employment decisions to assure a lifetime family insurance package with a premium covered through pension.

So when I hear smart people tell me we need reform I say, why man, why?  How will this reform affect what just happened in our lives? Is it gonna change the insurance we have in anyway and how do you know? If you can answer my question about what happens to every penny of the adjustment then I will listen to your theory, if you can’t then you don’t understand anymore than I do.

I believe in Newton’s Law of Motion that every action has an equal and opposite reaction. I am watching with considerable interest/concern to see what happens next.

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A Favorite Life Lesson

Many may have seen this, it is not new, but it is universally applicable to all human beings and one of my all time favorite “self helpism’s.”

Autobiography in Five Short Chapters

By Portia Nelson

Chapter I

I walk down the street.
There is a deep hole in the sidewalk.
I fall in
I am lost . . . I am helpless
It isn’t my fault.
It takes forever to find a way out.

Chapter II

I walk down the same street.
There is a deep hole in the sidewalk.
I pretend I don’t see it.
I fall in again.
I can’t believe I am in the same place.
But, it isn’t my fault.
It still takes a long time to get out.

Chapter III

I walk down the same street
There is a deep hole in the sidewalk.
I see it is there.
I still fall in . . . it’s a habit.
My eyes are open.
I know where I am.
It is my fault.
I get out immediately.

Chapter IV

I walk down the same street.
There is a deep hole in the sidewalk.
I walk around it.

Chapter V

I walk down another street.

The Blue Unicorn

An economic developer does not always get to choose his projects sometimes they choose him. It makes for interesting encounters at times. Having worked both rural and urban environments I would opine that the chief distinction is that urban typically has more infrastructure to support more sophisticated projects so the players are often more sophisticated. As with all cross sections of life there are good and bad guys coexisting in development at the same time (sometimes together) so what appears to be reality can sometimes be a wolf in sheep’s clothing. The successful practitioner soon develops a sixth sense on what is real and what is BS, and uses that to protect against false steps. It’s amazing how closely the blogging world resembles that analogy. (Perhaps)

I remember once about 15 years ago I had a couple of guys drive up in a Limo and ask for some time. So I listened to their proposal for my small county. It was a movie about a blue unicorn. And the story line was “so great” that it would become an American Icon and they would then develop a theme park to rival Disney. Sounded a little far fetched, especially since their suits looked like they came from the Salvation Army Store. I checked out the Limo and it was rented from my chairman who ran an auto dealership. He made them pay cash for the rental for 2 hours and only put a quarter tank of gas in it. I asked them for a business plan and they didn’t have one. So I asked for a copy of the script and they said it was almost finished. So I suggested they come back with both of those before I assembled potential investment partners or State sources of grants. Turned out that they had just been released from prison where they had taken a business entrepreneurial course and they were applying what they had learned. Like most crooks though they were lazy and didn’t work the scam hard enough. Their plan was to generate verbal support and run a pyramid scheme on that.

The thought occurred to me recently how closely certain bloggers resemble that pair. It really wouldn’t be hard to sit in prison or in a public library and invent all kinds of extraordinary daily adventures AKA Walter Mitty. Most everything can be vague enough to be documented via the internet and appear to be legit. It is especially effective when a pair is working the con. Personally I have found the busier I get the less time I have for blogging so I am always a little bit skeptical when globe trotters have oodles of time to document their exploits. Name dropping is another red flag; it frequently denotes a strong lack of confidence and satiates an ever growing narcissistic need for false envy.

Really clever folk will target their vics through analyzing their on line persona and supplying a sympathetic profile that attracts the protective instincts. I suppose there is nothing really illegal with that part of the deal as long as one can see through the veneer and not get burnt too badly.

The old adage is frequently correct, “if it looks to good to be true it probably isn’t.”