Monday, July 27, 2009

Belted

Important stuff first: my daughter passed her orange belt test. And, truth to tell, it looked like a real test. I was a little afraid that it might be a deal where they implicitly said 'you've been coming here for six months, you're not a klutz, have a new belt'.Not so. It struck me as moderately stressful, moderately losable. Her moves were a little soft, occasionally off. But she passed. She had to get a 70, overall, and she got a 91. Way cool.

One side note -- we brought a girl along, a friend of my daughter's. She pointed out that one of the other students seemed reluctant to 'attack' her. She thinks he has a crush on her. A crush on my daughter? Grumble.....

I didn't get the Washington Post this week -- they don't deliver it to the small Pennsylvania town where my MIL lives -- but I was able to get the New York Times. I have to admit, the Times frequently feels more substantive to me than the Post. We read the Post because we like having the comics (for humor, the Times has a summary of what Sarah Palin's done lately, but I guess that'll die down now. At least, I hope it will), and because we agree with their general attitude toward things. Of course, the attitude of the writer and the paper are in no way reflected in how the news is reported -- of course-- but the opinion articles are fun to read, for the most part. (Some are a little too liberal even for me... and, amazingly, there are people who regard them as too conservative).

One of the articles in the Times' Week in Review section was Forget Who Pays, It's Who Sets Costs, about the question of health care costs. It asks whether doctors should be able to determine their own salary by allowing them to determine what services are needed -- services for which they are paid. There's always the assumption that if you ask someone who provides a service whether you need that service, they'll say yes (my father would occasionally say 'Never ask a barber if you need a haircut'). I'm sure everyone has a story about that -- I recall that a dentist I used to see in Dallas started recommending more procedures after he got married. Still, I tend to think (and this is more a guess than thinking; I don't have any substantive knowledge) that the great majority of doctors don't practice medicine for the money. Like anyone else, they're not unaware of it, but they do what they think is right -- sometimes to their own benefit, and sometimes contrary to their own benefit. The article says that people don't tend to blame the doctors, and the tests they order, for the high cost of health care -- they blame insurance companies and malpractice laws, both of which have been found to be less a cause than those tests. I must admit, I'm surprised that there are doctors who are willing to come out and say that the fee-for-service model is wrong. I'd bet that it's not completely wrong -- sort of like when my daughter wanted to switch to a different billing plan for her text messages, and I pointed out that mapping the cost for one billing system versus the other, if she used more than seven minutes a day, her current system was better. (She switched anyway!) I tend to think that clearer costs would make the medical decisions easier -- even though there will be plenty of times when you say Damn the cost, fix this!

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