Dealing with health care

Many welfare states, like the Scandinavian countries, and even others like Canada and the UK believe that health care for the population is a right. Everybody needs to have access to, and be assured of, reasonably good treatment. They pay high taxes to cover the cost of universal single payer coverage. The US believes that health care is expensive, taxes should be low, individuals need to pay for high quality care, and companies and doctors should have a high return to motivate them to provide the best in the world. Some assistance is provided to the aged and indigent. Many get excluded in the process.

Case 1: A sliver of wood from the floor entered the sole of my foot. I yanked it out but a few days later, realized I had left a piece behind. It was parallel to the sole, so did not pain or pinch, but could be clearly felt when the area was pressed. Work made me put away attending to it. A week later, I called my primary care physician, who I have been seeing for about 18 years. His front office informed me that this requires intervention, and his office is not covered by insurance for that. I need to go to the walk-in clinic at the hospital.

I did that a week later.  The nursing assistant listened to my story and said they do not do interventions, and she would have to send me to the Emergency Room side of the hospital. I demurred, asking if that wasn’t expensive? She said yes, and then offered to speak to the doctor in attendance at the clinic. A short while later, the doctor walked in, examined my sole with a magnifying glass, and said that if I had come right away, it may have been possible to remove it. It was now embedded and the area was inflamed. He did not recommend digging around and said that if it was a metal or a glass sliver, it would come to the surface on its own. Being wood, of cellulosic material, the body would absorb it and I need not do anything. I asked how long I should wait, and he said to visit the Emergency room after a week if it is not gone! I was charged $198 as my share of this consultation.

A week later, the sliver was still bothering me, more mentally than physically. I looked up the web and found an AFC Urgent Care unit in Arlington, near me. I went there. The front office comforted me by saying that their charges are more reasonable than the emergency room. I was then attended to by a ‘physician’s assistant’ who looked not older than about 22. She breezily announced that yes, we can deal with this. A short while later, she returned with a longish needle, and after poking about in the spot, removed it with a pair of forceps and displayed it to me. Done! What my sister would have done with a safety pin, had she been around. I received a bill for $236, being my share of the costs. So my share of the expenses to remove a wood sliver from my sole was $434, under the high deductible health insurance plan that I was on.

Case 2: A year ago, I had my cataract removed from one eye, involving one ophthalmic surgeon consultation before, lots of tests, surgery, and three follow-up visits. I was under a different health plan with higher premium and lower deductibles, and my costs were nil.

My two eye drops to treat glaucoma, in the US, costs me (my co-pay) $40. The same medicines are available as one (same manufacturer) in India, and it costs me Rs. 850, or about $12, retail, no insurance.

Case 3: While on a visit to Chennai (India) during the summer of 2019, I felt the need to visit an ENT physician to check on my vertigo and my suspicion that my hearing was dulled. (Students in the last rows were not audible.) I visited the doctor, who sent me off for a hearing test (Rs. 700). I went back to the doctor, who examined me, saw the report and said there was nothing wrong with my hearing, he did not want to medicate me for the vertigo since he thought it was random and not serious, and to return if and when I really had a problem! His consultation fees: Rs. 500. Total costs: Rs. 1200, or about $ 17.

These are random experiences of two different health systems! I am not offering any solutions for the health care of the world!

Library – A requiem

I love libraries. Ever since I was young. I used to cycle my way from my home in Royapettah to Mount Road in Chennai to hang around the British Council and USIS Libraries. It helped that they were air-conditioned and this was Madras! I went there often enough that the librarians started recognizing me and would smile. That was special.

I also visited the Connemara Library in Egmore and loved the gorgeous Victorian style building with all kinds of nooks and crannies within. I was a student volunteer in my Christian College High School library. My own Vivekananda College Library was relatively a dull and dreary place, with closed access to many of the sections. You could not walk about the racks and yank out a book to read. You have to tell one of the assistants who would get the book for you. That made me a frequent visitor to the librarian’s office and he took an interest in my career. When I told him that I was joining the B.A. in Economics program, his face dropped, and in a mournful tone asked me if my performance in the Pre University Course was so bad that I would not qualify for IIT.

The libraries rescued me in my final year of the BA program. Three months before the final year exam, I realized that even though I attended classes regularly, I did not know a thing about the subject. The solution was obvious! I borrowed books from different libraries and pored over them. Did not do too badly in the exam!

I even remember those after whom all these libraries are named. The Ratan Tata (senior!) Library at Delhi School (a lovely place with all the economics journals in the world you can think of) and the Vikram Sarabhai Library at IIMA. The names just ring in the mouth and connects all the synapses in the head.

Well, libraries I am told are dying. At least the one here at Suffolk University is. Being an urban campus, various other functions of the university are eyeing its space lasciviously. The Librarians’ own data shows that a very high percentage of the books have not been checked out even once, and so they are unable to defend the space. Many books are to be moved to the basement and one will have to requisition the books in the future. Students’ use the library just for group meetings or lounge in the chairs with earphones plugged in. I wonder what they listen. I hope it is an audio book. I do not see a single book in the bibliography of my students’ assignments.

But libraries are not just a place to borrow books! They are places where you get inspired! You can discover subjects even better than Google can! Sigh! David Godman, while a student in England, stumbled on a book while looking through the spirituality section and found it was about Ramana Maharshi. He read it, bought himself a ticket to Tiruvannamalai (where Ramana had lived and an ashram grew around him), and is still there, 30 years later.

Collect Stamps, Anyone?

As a philatelist (yes, a few of us are still alive), I bemoan the arrival of the email which has drastically reduced our use of the postal service to mail letters. Somehow, people nowadays feel that you should immediately know of the most inane events in their lives that in a previous era would fortunately have died in importance between the time they thought of it and got to a table with paper and pen. And of course, the less said of the prose and spelling you see in an email the better.

Getting back to stamps, I took a look at my collection. I had over 6000 stamps from 137 countries. (Yes, I counted.) Some of the countries don’t exist any more (like the UAR or Czechoslovakia) and surely they must be valuable? You see, I’ve been thinking. I saw an announcement of a ‘Road Show’ of philatelic agents hosted by the Spellman Museum of Philately in Weston, Massachusetts. The announcement also said that for $40, collectors can have their collections evaluated.

Surely, I thought, it was time I had my collection valued so I can bring forward my retirement date. So I lugged all seven volumes of the stuff and met the curator. A kindly gentleman, he chatted with me and made some nice comments about my collection (Oh, these British definitives have a nice color palette! ..You know, these two were the first stamps designed by children. Of course, now many countries do that… He smiled at several pages, and nodded.)

He finally looked up and asked if I had any specific questions. Of course! ‘I thought you would be able to give me a ball park value for the collection,’ I offered. ‘You know, we don’t really value them’, he began. Then he went on to observe that most of the stamps I had were cancelled ones, and being stamps in common use during their times, there are plenty of them, and so on. Finally it came. ‘If I was to put a value on them, it would probably be a couple of hundred dollars, certainly not in the thousand.’ It dawned on me that I had paid about 25% of the value of my collection to have it valued.

Oh well. One of the ironies of philately is that stamps are valued more if they are mint (i.e., new) and not cancelled (i.e., used). Yes, I do have all the common ones because I painstakingly collected them by pursuing those who got mail from overseas to give me the covers from which I carefully extracted the stamps. I was not going to throw money at dealers to build a collection. No Sir! For me, the whole point of a stamp collection was that the stamp had done its work (i.e., conveyed some mail across the country or countries), and now was ready to rest. The cancellation had its own story to tell (for example, a Dutch stamp with a cancellation from Soerabaja, (see picture) now Surabaya, in Indonesia, when it was still a colony). I love the stamps from Germany. There is the Germany of today, West Germany and German Democratic Republic from before, from the occupation zone during the war, and so on. Stamps teach you history!

Stamps tell you lovely stories of the culture and art of the country, their heroes, and travel spots. They convey to you what the country thinks is important (people and events). You could look at the stamp, wonder why they have put this plant on it, and then look it up to find out that the plant is a valuable and rare native species.

Sure, my collection does not have the 1867 15 cent Lincoln, now valued at $200,000. But so what, I thought, as I drove back home. My collection has given me hours of pleasure since the age of about 10 when an older cousin started me off with an extra album of his with some stamps already pasted in.

So, I decided to act before it was too late.  I’m going to make up a couple of albums and give them to Liam and Grace, the six year old twins across the street and tempt them into a glorious future.

And retirement can wait.

Image of colonization

I just finished reading Shashi Tharoor’s book ‘An era of darkness’ (Aleph, 2016). Interestingly, the book came about from a suggestion by the publisher after Tharoor’s Oxford Union debate video went viral. The book is a wonderful and devastating critique of colonization and its effects on the people. He has been able to bring together in one place arguments from several disciplinary perspectives, and kept it readable without losing the scholarly arguments.

History buffs will recognize several familiar arguments they have read elsewhere. Some earlier books criticizing colonization that I have read include: Reginal Reynolds, White Sahibs in India (1937); and most recently, Pavan Varma, Becoming Indian (2010). It is good news that the challenge to colonial sympathizers is picking up. Roy Moxham and Jon Wilson both have books that have come out recently (I am yet to read them). Although there is no new original research underlying Tharoor’s book, he has been able to convey a powerful story.

There are several aspects of the book that require particular mention. He calls Churchill for what he was – a racist. He takes the so called benefits of colonization, including the legal system, democracy, railways, etc. and points out either the flaws in the argument, or how they were all meant to serve British needs. His most engaging parts are where he argues the case of economic devastation, how British policy caused deindustrialization, famines, and tapped into the Indian treasury for all their nefarious activities. At times he becomes poetic. Referring to the retired British officials, he writes, ‘And at the end of it all, they went home to enjoy their retirements in damp little collates with Indian names, their alien rest cushioned by generous pensions supplied by Indian taxpayers.’

Tharoor’s writing style goes into each aspect in fair depth, dutifully explicating all the nuances and provides a rich bibliography.

Much of the arguments revolve around the use of ‘divide and rule’ by the British, who took it to a fine art and practiced it in several spheres – in laws, governance, religion, electorate, and so on. (Unfortunately, we must admit that it is such an effective way of dealing with people that our governments continue to use it!)

For too long have we left the apologists for colonization have their say without challenge. The most recent being Niall Ferguson, who comes in for a fair bit of criticism by Tharoor. Even history books and textbooks shy away from calling colonization for what it is, with the result that there are people in colonies even today who occasionally mouth the ‘things were better under ..’ argument.

A must read.

Language expression

‘If good poetry is hard
then drink champagne.’

That’s one of the bits of poetry that I have constructed on the door of my refrigerator. Another one is:

‘I know
the deep secret
of god’

You see, I have a box of those magnetic words and can combine the words to express myself on the door of the fridge. So, while I wait for the coffee to brew, or the mandatory three minutes for my tea bag to steep, I can express myself. The problem is that my imagination, and creativity, is limited by the words that the manufacturer has provided me in that little plastic box. (And by the amount of patience I have in searching for the right word, but we shall set this aside for the moment.)

My friend Tom, the linguist, put it in a very profound manner. ‘Ideas depend largely on language,’ he said. Of course, he was not commenting on my magnetic poetry skills but on the importance of learning one’s language well. And how different languages have evolved differently, allowing different words to develop to express the ideas and emotions of the people of that language. Every high school text on social studies will tell you that the Innuit have 23 (or 32?) words to describe different kinds of snow. The Tamils have no need of that. But they have a distinct word for every kind of familial relationship (mother’s older brother is different from younger, and from the father’s brothers!) Continue Reading