31 May 2007

Well Done, Mom, With Love

Today, My Mom retires after 34 years of teaching. At a time when many of her colleagues want her to stay and members of the community come up to her and ask her to "hold on" for a few more years so their children can be in her classroom, she has rightly decided it's time to go.

She leaves behind a rich legacy that seems to erupt around her when she moves through her hometown, a town that adopted her as a Distinguished Citizen over a decade ago. Thousands of students passed through her classroom, almost three generations from that quiet first morning, not so long ago, when My Mom stood in front of a classroom and said "Hi, my name is Mrs. Cruz."

She spent almost the entire run of her teaching career in junior high, primarily eighth grade. She told Me it was because those were the most difficult years, the transition period between child and young adult. It is no coincidence that that was where My school years went from veiled criticism to open confrontation, Me giving more than I got. She recognized that I was dealing with a vacuum, a limbo where no teacher made any real effort to reach out to Me and offer Me guidance. She made filling that vacuum her life's work.

Most of those 34 years, My Mom went to school every day, battling through pain, illness and just plain exhaustion to be a daily influence on her students. She isn't the only teacher to do that, but We don't cherish that enough. Even with a severely damaged elbow--destroyed, in fact--she made it to school barely 10 days after the incident and opened the school year. The day the incident happened, some 40 students walked two miles to the hospital, just to see her. The nurse there told Me she'd never seen anything like it in her almost 40 years of nursing.

This morning I called My Mom and told her I was proud of her and that her students were lucky to have her as a teacher. That's not Me, or at least, that's not the old Me. The old Me, the raging child in eighth grade, was terrified of having His Mom as His Teacher. It took Me years to understand that I already had her as My Teacher. And that I shared her with an ever-larger community.

My Mom's retired now, planning to do some tutoring in English to stay involved in teaching. Day by day, in a classroom I never saw, My Mom wove a tapestry of affection, caring and enthusiasm for Life. Every day was barely significant to many of those involved, but every day was another carefully-placed stitch, one whose end result was often not seen until years later. Because she cared for each school day, she crafted a rewarding career.

Yes, My Mom is a Teacher. Would that I learned as well as she teaches.

The Jenius Has Spoken.

28 May 2007

Stop The Murderous Moron

Only once in a while have I strayed from local interests to tackle another topic. I'm doing it again, simply because not doing it is no longer an option.

Here's an article in The Washington Post, written by a father whose son was killed on Mother's Day, in Iraq. Lest you think the writer is what the murderous moron in the White House calls "unpatriotic," Mr. Bacevich is a former Vietnam War officer, who opposes this war because this war, pretty much like Vietnam, is not needed.

Let's go back a moment to the subnormal criminal, the murderous moron, who infests the Oval Office. Did he serve in a war? Hell, no. He weaseled his way into a cushy I-can-drink job in the National Guard during the Vietnam War...and weaseled his way out of it without serving his commitment. That brief description there sums up what's wrong with this cretin: Born of privilege, yet bereft of a sense of responsibility; unable to control his baser instincts, a cut-and-run screw-up with tunnel vision product of a sliver-sized intellect.

And yet, such is the power of money in the U.S. of part of A., that even a morally-bankrupt, brain-deficient louse can lead the nation and get thousands of its citizens killed, with many more thousands maimed, in the name of "patriotism."

Mr. Bacevich opposed the war his son served in. He has had the horrible, unspeakable tragedy of knowing that his son was killed in a useless war, one based on lies, fueled by greed and apathy, a useless war launched by a man unworthy to even wear the same uniform he and his son did.

So here We are, on Memorial Day, rendering tribute to the millions of men and women, including My father, who served in war and peace. And yet, while We rightly do that, We should also remember to look long and hard--again--at the murderous moron, the illegitimate commander who keeps sending Our relatives and friends into harm's way. He should be stopped. He should have been stopped long ago. That failure will haunt many of Us. And if you doubt that, just ask Mr. Bacevich, or any other grieving victim, of the murderous moron.

The Jenius Has Spoken.

26 May 2007

Happy 7th, Kaleb!

Happy Birthday! I've been teasing you all year with the notion that there is no "May 26th" on the calendar because We're doubling up on "November 12" and yet, here it is! Goes to show how much I know about time...

From last year's divorce, which happened in the gray regions that surround your daily life and Grandpa's death, which happened virtually in front of you, the year has been shadowed by sadness. Maybe it's Me, but I can see those shadows in your eyes, in the muted dimness of your smile and in the sidelong glances you use to assess the world.

Or maybe it's just the process of growing up, of becoming more aware of the world and thus less open to it. Your mom has told Me of the many questions you asked her about Grandpa's death, of where he's gone, why he left, what that means to you, to her and what would happen if I died, too. She answered all your questions and for that I'm grateful. You asked Me fewer questions, but they were more pointed, more concrete: Did Grandpa know he was going to die? Was he in pain? When will Grandpa's ashes be placed in Orocovis?

Last week you told Me We had to "give" something to Grandpa on Father's Day. I confess the idea caught Me by surprise, for I was planning to celebrate his birthday (August 4), but Father's Day seemed much better. After discussing it with My sister, We decided to continue sponsoring a child, as Grandpa did for over 20 years. You, your cousins, Aunt Vi Marie, Grandma and I will pool monies and give a gift in Grandpa's name, celebrating Father's Day for Us and in his memory.

In many ways, you've come out stronger from the last year. You're certainly a better student and you've developed many interests, from coins to Egypt to classic cars. I watch you grow, make you laugh, listen to your concerns, laugh at your occasional jokes and enjoy playing whatever it is that We're playing at the time...but I worry. I wonder if I'm the best father I can be, if My choices are truly best for you and if My limitations might hold you back in some crucial way. I guess that's only natural, but I know I can only do so much. Who you are and what you will be is largely up to you. And you're doing a wonderful job.

So continue tolerating Me with your soft smile whenever I press down on your head to "keep you from growing," or shake your head like a wise old man when I "blame" you for something I screwed up or giggling like a mad elf when I invite you to lunch at Pep Boys. I'm so happy you're My son. I'm so happy you're seven. I'm so happy We can be seven together.

The Jenius Has Spoken.

25 May 2007

1-in-20 = Kaizen

One of the great things--to Me--about baseball is that it accurately reflects the general pattern of Life: You don't have to be amazingly great to be a success, you simply have to be a little more consistent at being good.

If you get 5 hits in 20 at bats, you are an average player. If you get 6 hits in 20 at bats, you are a superstar. And if you keep getting just one more hit per 20 at bats long enough, you are a Hall of Famer.

If your team wins 12 games out of 20, it is an outstanding team. But win 13 out of 20 over the course of a season and you are almost certainly going to be on the championship team. (Your mileage may vary.)

In any case, notice the almost quantum leap in perceived results from the minuscule change of 1-in-20. Did you ever consider just 5% the difference between a regular Joe and Joe DiMaggio?

Now ponder that difference and apply it to society as a whole. Or better yet, apply it to yourself. How much better would your position, value, career, your Life be if you simply improved "1-in-20"? You can quickly determine the potential impact in your job and thus, on your career. And if your career improves, what does that do for your Life?

Now don't give Me that "Nobody will notice in my job" whine. YOU will notice, and as you begin to notice the difference and what it means to you, you will automatically begin to notice new opportunities. And if you have a job where "nobody notices," then having seen more opportunities around you is the basis for finding a better job. Or for creating one.

The same applies to Our communities and, by extension, Our society. We don't have to change everything at once: What We need to change is very little and by doing it consistently, We get the cumulative effect of small positive changes adding up to large, massive and even monumental change.

The Japanese call it kaizen, the process of continuous improvement. In baseball, and Life, it's called being a winner. Given where We are and where We need to be, it's definitely time We started Our own 1-in-20 kaizen path to winning.

The Jenius Has Spoken.

23 May 2007

Joint Irrelevance

Let's see...

Stupid Rosselló is a candidate for governor in his shellacked, shell-shocked and hell-bound party.

Got that one.

And Puerto Rico's bonds were downgraded--again--to less than BBB status. Yep, got that one right, too.

Let's deal with the failure first. Stupid Rosselló primped and preened his sorry self in a grotesque version of a whore impersonating a virgin pretending he wasn't "in the race" for governor. Poppycock. As predicted--not only by Me, I must add--the party poopheads "acclaimed" him until, in a show of reluctance as believable as weapons of mass destruction in Baghdad, Stupid Rosselló accepted the party's "plea."

With a condition: He would not run a primary campaign. That's like being a horse's ass in the Kentucky Derby: You're there, but you aren't actually running in the race.

I say We let him be a horse's ass because he simply reveals he is a cowardly horse's ass. At a time when Puerto Rico needs solutions and progressive vision, Stupid Rosselló shackles a party to non-progress and childish posturing. And there are those among Us who believe this horse's ass can walk on water. I say he can prove it...in My toilet.

And speaking of toilets and down the drain and floating crap: Our bonds. A friend argued that I'm not entirely right because they haven't been classified as "junk" by either Standard & Poor's or Moody's. But if the lowest "acceptable" rating for a bond is BBB and you go down to BBB-, would you call that a sideways move from "near junk" to "pretty near junk"? The rating doesn't matter a whit. What does matter is that last year, The Fools were all over the airwaves shrieking "junk bond doom" and how the --wait for it!--sales tax would keep Us from falling into that horrible horrible hole.

Well, We're in the horrible hole, We have a sales tax and Stupid Rosselló is still hanging on, the "not there" governor and the "not there" senator is now the "not there" candidate, joining Our "not there" bonds in joint irrelevance.

I'm far from the only one wishing The Fools, the hole, the Stupid and the junk bonds were "not here."

The Jenius Has Spoken.

21 May 2007

Blatantly Stupid

The Puerto Rico Department of (Mis)Education has the immense, atrocious, unbelievable gall to claim that the student dropout rate in the local school system is 1%.

One. Percent. The lowest in the nation, even.

Are you fucking kidding Me? The acknowledged cesspool of the the swampy U.S. of part of A. education system has the unmitigated chutzpah, the barefaced fuerza de cara to utter such an IDIOTIC claim, somehow expecting it to be accepted? Rafael "Bow-tie Boy" Aragunde, secretary of the misbegotten department, feebly commented that the number was "woefully" far from reality.

No spit, Shylock. You want fries with that? And as a follow-up question: How would you know, Bow-tie Blob?

For years--years, people--this same cesspool of a department has avoided reporting or even quantifying the dropout rate. In some schools, the dropout rate is close to 50% over a 3-year span (grades 10-12.) I know, for I used to live a mile from one such school. According to a municipal study, the Caguas school district has a dropout rate of over 40%, despite ranking as one of the top 5 of the 10 local school districts.

Look, Bow-tie Boob and percentage perverts: It doesn't take a Jenius to figure out that if 15,000 students start first grade and only 8,000 graduate from high school, then there is a major problem with dropouts. We've had it for decades and trying to cover it up with a stupid, stupid claim like "1%" is like putting makeup on a horse's ass and calling it art. That's a politician's job, not an educator's.

Here's a suggestion, Bow-tie Bobo: Determine the dropout rate. Anybody with basic math and research skills could easily do it in a week, so hire somebody to do it (obviously, nobody in your whole friggin' department is qualified.) Post that percentage: overall, by district, region and school. Then challenge everybody in your sorry-ass department to make those numbers come down. Not by erasing or fudging or lying or ignoring them, but by improving the retention rate of students.

Will it work? Who knows? But one thing's for sure: We can't do worse than We're doing now. At least when We have the truth, We can start moving forward. Lying by omission and by simply lying like a dog is not the way forward.

I thought you would have learned that by now, Bow-tie Blowhard.

The Jenius Has Spoken.

18 May 2007

Reading Vignettes

Funny how Life has a way of merging ideas and interests...From Lawrence Harrison's Underdevelopment is a State of Mind: The Latin American Case, a few snippets to blend with My recent vignettes:

-- Related to My remark about the cultural duality of "science fiction verses magical realism": If the society's worldview encourages the belief that humans have the capacity to know and understand the world around them, that the universe operates according to largely decipherable patterns of laws, and that the scientific method can unlock many secrets of the unknown, it is clearly imparting a set of attitudes tightly linked to the ideas of progress and change. If the worldview explains worldly phenomena by supernatural forces, often in the form of numerous capricious gods and goddesses who demand obeisance from humans, there is little room for reason, education, planning or progress.

We believe the world around Us simply happens, that it is "God's will" or "the way things are" that things turn out the way they do, regardless of Our efforts. Science fiction is Man making things happen, whereas magical realism is the wordy complicated version of "Shit happens."

--Covering part of My remark about The Fools needing to change their mindset: When the idea of compromise--i.e., that a relationship is important enough to warrant seeking to avoid confrontation, even if some concession is necessary--is weak, the likelihood of confrontation is increased. Constant confrontation undermines stability and continuity, which, as noted earlier, are crucial to development.

The relationship Harrison refers to is simply Our progress, Our overall chance to develop Our potential. By and large, We give a tinker's damn about that, choosing petty individual concerns over a greater goal of common good. It isn't Our institutions that suck, it's Our attitudes.

--Related to that and rapping Me upside the head: If the idea of progress is well-established in the culture, there is a presumption that planning and hard work will be rewarded by increased income and improved living conditions.

We don't have a deeply-ingrained cultural mindset of self-made progress. A few of Us do, and if of these few the attitude goes from optimism to pessimism, then We are truly up Fecal Creek without a rowing implement. Harrison is right that culture, specifically the Spanish-based culture We have, is an impediment to greater development. But cultures are not static. We can't choose Our culture, but We can certainly choose Our attitude within it.

It's just that too many of Us keeping making the absolute worst choices possible.

The Jenius Has Spoken.

16 May 2007

No Talking Zone

Over at El Gringoqueño, James O'Malley blogs about two employer-employees "styles": the "Asian manager-lets-underlings speak" and the "American employees-speak-up" style. He goes on to make the following observation:

What happens when you have managers that will not extract opinions from employees AND employees that are so deferential they will not offer them?

Well, my friends, you have Puerto Rico, a workforce culture that combines two models in the worst possible way, an employee class waiting to be utilized and a management class that will not seek information.

In either case, Asian or American, there is a flow of dialog. Managers may initiate in general in Asia. Employees may engage more in America. In Puerto Rico, the two are completely disconnected. Managers want to play golf and receive the treatment and privilege of royalty without having to speak to the help, and employees are scared to stick their necks out for fear of being whacked.

Does that sound like a recipe for success?

Actually it sounds to me like a recipe for revolt.

Now, James is really a nice guy and he doesn't slam the point home the way I would, most likely because he feels it would be taken as a gringo point of view and deemed--oddly enough--less valid than a boricua's. Balderdash. James is right and he'd be right even if he were from some incredibly alien place, like say, St. Louis.

Employees here are closer to zombies than normal. They do have brains, though: Just drop by any watering-hole or lunch counter and you will hear an endless barrage of opinions, ideas, slams, observations and conclusions about the job, the office, the boss, the other bosses and their prospects for the future than you can shake a stick at. But watch them back in the workplace and you can see Dawn of the Living Dead in 3D.

It all boils down to insecurity. The average employee here is too insecure to attempt any action that could be deemed risky. We get that from a school system built to crush initiative and from a cultural mindset that tells Us constantly that We must wait to receive.

On the other side--management--the insecurity comes out as "I know better because I've been given this title." Given. Title, as in enTITLEd. Since you must wait to receive, once you get it, you feel entitled to lord it over the rest. And since you were given the title, you are afraid it can be taken away, so you don't want anybody making you look bad, so it's better that the hired hands keep their pieholes shut.

Most employees don't want to speak up to avoid becoming targets. Most managers want employees to shut up so they can feel secure in their positions. I think they're all idiots. But their idiocy is dragging Us down and no one seems compelled to do anything about it.

Misery, fear, insecurity, weakness, rampant idiocy... Ingredients for a revolt, indubitably.

The Jenius Has Spoken.

14 May 2007

Fear of Choice

From the fertile mind of George Carlin, a succint description of Purgatory-on-Earth.

Most people work just hard enough not to get fired and get paid just enough money not to quit.

Why? Why do people settle for this obnoxious, life-sapping, painful existence?

Fear? Of course. Fear of failure, fear of success, fear of being different, fear of angering mommy and daddy and the neighbors and who knows who else... Fear as the ruling force in life. How utterly deplorable.

Envy? Certainly. It's easier to rail against the rich and successful, to wallow in green-eyed jealousy than to admit that what they have is often earned. Easier to sling blame like runny mud than to accept that they are no better than I and therefore--therefore!--I can do the same. (Here's a visual.) For in acknowledging that agonizing Truth, one must accept the sibling Truth that one is afraid to try. And We're back to Fear again.

Ignorance? Maybe. Not as a natural characteristic, for self-interest is practically genetic, but as an acquired deficiency, product of sloppy thinking perpetrated by schools, religions and the massive ignorance of the crowds. "Do as you're told!" "Put others before you!" "You were born poor and you can't be rich!" Crap, all of it. But if you know it's crap and still believe in it and remain in Purgatory-on-Earth, then it bears asking again: Why? And I'm sure We'll hit Fear not too far down that road.

Apathy? Conformity taken to the extreme of self-denial? Wallowing in quiet desperation or even total freaking numbness? Is that Life? It is only if you consider mummies go-getters.

Day after day, a marginal existence where pain outweighs pleasure, where hope is a distant background to anxiety, where alcohol and soap operas and lotteries not only make sense, they are deemed necessary, a barely-tolerable stumble through Purgatory while others--almost molecularly similar--dance and skip through Life.

It boils down--as ever--to choice. Maybe that's the ultimate Fear that saps life from Life and leads to Purgatory-on-Earth: The Fear of Choice. How utterly deplorable. How utterly...common.

The Jenius Has Spoken.

11 May 2007

Conversational Vignettes

Brief vignettes of conversations I had yesterday:

--"I'm not as optimistic about Puerto Rico as I once was." Said to a woman who still retains her optimism, though she acknowledges that pessimism is more the cultural norm here. I hope to explore My change in viewpoint and regain its purer essence in conversations with her very soon.

--"To Us, 'simplify' means 'Add another step." Said in response to an economic analysis of competitiveness and economic effectiveness that places simplifying the business environment as a major factor in enhancing growth. We seem to worship red tape and like fish in water, We don't even have a specific term for it other than "bureaucracy." The world's abnormal is Our übernormal.

--"You're being shunted aside by technology, so how are you using it?" Spoken to the head of a local realtor's group whose main concern is professional reputation, not technology. I now realize it led to the next remark, spoken over lunch...

--"To Anglo-Saxons, science fiction is most attractive; to Latins, it's magical realism." I've used this analogy before to illustrate the cultural differences between the U.S. and most of Europe's love and acceptance of technology versus Puerto Rico and Latin America's slower reponse to it. Yes, there's an economic component, but the exception--the rocket-like rise of cell phones--proves the point: We adopt technology if it clearly and distinctly links Us on a human level and not just "Technology for technology's sake." Until We overcome that cultural difference, Our tech efforts will always lag behind in growth rate.

--"Given that We are so driven to connect with others, We should be dominating the development of social networking software." Again, not a new thought. The flip-side of not liking technology in preference for social interaction is that We are best-equipped to modify technology in service to social interaction. Why We aren't doing it is baffling: We have the programming skill, the perfect social laboratory and an entire world ready to embrace it. Maybe that's the problem: We don't know there's a world out there.

--"E-goverment is not about changing government, it's about changing decisions." In response to a pontificating egghead who was making the case for wholesale Executive and Legislative branch changes in order to implement strong e-government initiatives in Puerto Rico. I'm all for kicking The Fools, but the bottom line here is that they have to decide to make the change and We--as citizens--have to decide to support and use it. Unless We change these mindsets, e-government, based on technology and embracing it, will forever remain a pipe dream.

--"It must be a good day when a Fortune 500 CEO and a waiter are both glad to see you." Happened during lunch, to the open surprise of several people around Me. And I wasn't even wearing My fedora...

The Jenius Has Spoken.

09 May 2007

Hilton's Plaza

It was an odd night, at least for Me. I wasn't exactly tired, or bored, or upset or angry: I was just...off.

Now many of My Jenial Friends will say I'm off more often than not, that in fact, I'm the living definition of off. But even if that were true, there are times when even My alleged offness is...off. This was one of those times.

I drove the few minutes to the town plaza. Unlike most town plazas in Puerto Rico, the Cabo Rojo plaza is alive and well in its role as a family-gathering place. Central to this success is the coffee-and-candy kiosk tucked to one side, a small haven for rich brews and excellent snacks. Its owner, a beret-wearing cultural force named Hilton, has spent the past 9 years fomenting a wide range of activites in the plaza, from poetry readings and artisan fairs to classical music concerts and film showings.

He does this by sheer force of will sometimes, battering past silly government red tape and often-indifferent residents. But in the end, Hilton has not only created a successful small business, he has been the catalyst of social change.

The Cabo Rojo plaza is usually filled with people and activity until well past 11:00 p.m. A typical night might have 3-4 handcraft tables displaying wares, a group of teenagers practicing a dance routine upon the acoustic stage, dozens of couples in animated conversation, several strollers, toddlers and kids with parents in tow, college students discussing those things only college students seem to do and senior citizens strolling and sipping coffee amidst a glow of nostalgia.

People come from several towns away to buy coffee and take in the plaza's ambiance. So successful is Hilton's little shop that other towns have tried to emulate his formula. It hasn't worked, for it's not the shop that makes the difference, it's the man inside it. Sadly, We don't really support the development of men and women like Hilton: We seem to do everything in Our power to beat them away with trifles and bureaucracy. What made Hilton a success was his simple refusal--time and again--to take no for an answer. What makes the Cabo Rojo plaza a success is largely Hilton's efforts. In that sense, it can be said We are blessed with Hilton's Plaza.

So I sat and sipped, watched and commented (to Myself, My best audience) and after an hour or so, I got back into My car and drove home. I'd spent some time in Hilton's Plaza, on My own terms, in My own quiet way and could now go back to My regular--or not-so-regular--life. Thanks to a man who set out to make a difference and used coffee, milk, candies, sandwiches and an indomitable will, I and so many others have the chance to sit, sip and reconnect. Drop by if you're in the area, for it can be said without reservation that Hilton's Plaza is your place, too.

The Jenius Has Spoken.

07 May 2007

Four Things to Forget

This won't take long...

Here are four things Puerto Rico can do--right now--to improve its general situation:

1) Forget party politics and focus on realpolitik. Party colors are waved to distract and manipulate. The dumber you are, the more party-focused you become. It's that simple. And We can't thrive on stupidity.

2) Forget the "Us Focus" and look at what's happening around the world. We believe the Universe ends at Our shores, with occasional flashes from Orlando, the Bronx and Washington D.C. In that sense, We're pathetically unprepared for a global role simply because We already think We have one just for being Us in Puerto Rico.

3) Forget the local media and embrace the Internet. Our media is, at its best, retarded. We have basically one newspaper and a horde of ad-sponsored (toilet) papers. Radio is a wasteland of noise (the music's great, but that ain't making Us grow) and what passes for TV news is a packaged laxative, meant to drain rather than inform. A global outlook needs a global source of information, hence the Internet. (And no, the idiots at the Internet Society of Puerto Rico and the Sales and Marketing Executives have it wrong: We are NOT--NOT--80% "on the Internet." Stop lying.)

4) Forget that "Learning is for children" and make learning a daily step forward. We often wade happily in Our lack of reading, lack of curiosity and lack of knowledge, literally in bliss with Our ignorance. That has to end. It lets The Fools rape Our Economy, lets other countries leave Us in their dust, keeps Us off the global stage We can dominate in Our own way and makes Us nothing but a sad footnote in the grand narrative of the world.

We're so good at forgetting that forgetting these things should be easy.

The Jenius Has Spoken.

04 May 2007

My Town, Good and Bad

This might be a small thing, but I have to mention it. Over the past seven years, I have had to get original birth, marriage and death certificates several times. My local Demographic Registry office is on the second floor of the Municipal Hospital, now in private hands. Although parking can sometimes be a little difficult and one now walks through the Emergency waiting room to get to the Registry office, not once has it taken Me more than 10 minutes to get any number of certificates.

Not once. The Registry is connected to a central database so that practically any request for a local certificate can be served. The procedure is fast and with one exception (a computer malfunction), every certificate was handed to Me within 2-3 minutes. How gratifying is that?

On the other hand, take Carbonell Hell, the main street "repair" job I mentioned back in July of last year. Almost ten months later it is still under construction, having undergone the following:

--A fallow period that lasted until the first day of school--just as predicted--when a work brigade with several pieces of equipment blocked the street during the heaviest traffic periods.

--Four months of mainly cosmetic work (literally sweeping, replacing the orange barrels, filling in ruts, painting the curbside[!], then tearing out the curbside--I kid thee not--to "expand" the street again) followed by a Thanksgiving-Christmas-New Year's-Valentine's Day vacation period.

--Concrete dividers were set up to narrow traffic at the "downtown" curve and the already-repaired street was torn up again, a process that moved back towards the the main highway, including two deep trenches and two narrow ruts. The trenches are now covered with heavy steel plates and the ruts are open, creating axle-wrenching, dust-spewing traps. All this marvelously inexplicable construction carried out--of course--solely during daytime traffic.

In short, Carbonell Street is more gutted than it was last July and possibly further from completion by any measurable standard. Just two weeks ago a digging machine was carving out a 12-foot hole three coffins wide. I walked over to the hole, ignoring every wave and shout to stay out of the work area and looked down.

Nothing. No pipes, no wires, no cables, no oil, radium, gold, bones, pottery, wood or even water. Just a hole. A safety vest with a shiny yellow helmet interrupted My view. "Move back," he said, taking Me for a nosy gringo. I looked at him and his ten colleagues, seeing slack-jawed idiocy as a hot fashion trend.

I walked away. What could I say? But I did smile at the fact that I walked the entire length of Carbonell Hell, crossed the highway, retrieved My car and was on My way in less time than it took the front car in the line to get past the useless work.

Small victories in My town, good and bad.

The Jenius Has Spoken.

02 May 2007

Beyond (De)Capitation

Note: Shout-outs to Janine Mendes-Franco, who selected another of My recent posts for Global Voices Online and to Raúl José, of De todo como en botica, for including Me in his analysis of Stupid Rosselló's pathetic mewl for attention.

From a dear friend, much more evidence beyond capitation that the health care system is a mangled wreck. Statehooders, try to understand that the following happened in the States, okay?

The whole area of medical care is COMPLETELY MESSED UP (and capitation is just one symptom of that).

My main complaint--medical care is basically the ONLY place where the price tag associated with something is completely irrelevant to the end user. People want to walk into a pharmacy and pay their $10 co-pay, regardless of the cost of the drug. Consumers have NO incentive to make rational decisions because they are shielded from the actual cost of care. (Why SHOULD I take the generic or an older drug if my copay is the same for the spiffiest name-brand drug? And why should I take over-the-counter Claritin and pay the full cost when I can take Zyrtec which is still covered under my drug plan?)

You also don't see the price tag until it's too late. Look at Don's broken toe from last year. His $1000 toe. He went to an emergency room at a facility on our list of "Approved Providers." We got their bill - $500 - even though he never got past the waiting room and a triage "curtain." Then we got the doctor's bill - $455. The doctor spent less then 3 minutes with Don. Looked at his toe, gave it a mighty yank, and told an assistant to "buddy-tape" it. For that, we were billed for two separate procedures (one labeled "SURGERY"). That's a heck of an hourly billing rate. And the story gets better... The doctors in the emergency room aren't a part of ANY insurer's plan. They can charge whatever they please and you just have to pay it. No negotiated fees. No discounts. Do not pass go, and pay way more than $200. AND--this is the kicker--although they don't recognize our insurance, because we HAVE insurance, they wouldn't discount the bill (claimed they "COULDN'T"). So we were stuck paying their highway robbery rate of $455. The only reasonable bill was from the radiologist - $11.55 to read the x-ray.

We TRIED to shop--went to what we THOUGHT was a facility covered by our plan. But there's no transparency in the pricing or anything else in the process. That's one of my problems with it.

I have a pharmacist friend in Louisiana who works with a lot of Medicaid patients. Because THEY aren't paying ANYTHING for their prescriptions, it is amazing how picky they can be. They get the name-brand drugs (no generic drugs for them - those are reserved for the paying customers with insurance). She's had parents return a drug because, "My child didn't like the taste of it." They wanted a different drug, AND THE DOCTOR GAVE IT TO THEM. (My child would have been told, "Swallow it. I know it tastes bad, but GET OVER IT.")

Society wants the easy fix ("diet and exercise" would sometimes work as well as a drug, but we want to be able to "supersize our fries," then take a pill for our cholesterol). What happened to personal responsibility? If you watch the drug ads, it doesn't need to exist. Pharma has a cure for whatever ill you may have or think you have. Drug ads make me crazy.

There are too many special-interest groups with VERY vested interests in maintaining the status quo. There are many INDIVIDUALS who like the status quo, too (mainly those with rich employer-provided health plans - just even WHISPER about changing a health plan at a unionized facility and watch the union squawk).

If there isn't a link between the COST and the SERVICE, then individuals will naturally want the most expensive (not most cost-effective) option. People have no incentive to self-regulate their demand for services, or to seek the most cost-efficient options. To me, that indicates a broken system. There will be no easy fixes, and fixes will not be popular.

We have a $10k deductible. I have plenty of reason to try to control what I am paying, but I'm not given the tools to do it. (Just look at our toe experience...)

Imagine: The richest, most successful country in history has a health-care system built on any number of factors... except actual health-care. And rather than seek a better solution, We play "Monkey see, monkey do".

However, in Our defense, so long as We are beholden to the Big Monkeys from the north--Medicare, insurance companies, pharmaceutical companies, etc.--and their incessant lobbying to keep a broken system broken, We'll just have to play along. It's not like We've ever had a real doctor in charge to try to make a difference, right?

The Jenius Has Spoken.