The Extraordinarily Keen Poetry of the Universe

From today’s New York Times:

Former Vice President Dick Cheney is recuperating from surgery to implant the kind of mechanical pump now being given to a small but growing number of people with heart failure so severe that they would most likely die within a few months without it.The pumps are partial artificial hearts known as ventricular assist devices, and they come in various models. Mr. Cheney’s kind is about the size of a D battery and leaves most recipients without a pulse because it pushes blood continuously instead of mimicking the heart’s own pulsatile beat. Most such pulse-less patients feel nothing unusual. But they are urged to wear bracelets or other identifications to alert emergency room doctors as to why they have no pulse.

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21 Responses to “The Extraordinarily Keen Poetry of the Universe”

  1. JD Says:

    Making fun of someone’s medical problems, especially life-threatening ones, is inappropriate, regardless of that person’s politics.

    • markbittner Says:

      I’m not making fun of anyone’s medical problems. I’m pointing out the extraordinary irony of the situation. And the issue is not his politics so much as it is his character, which forms his “politics.” He is a cold, cruel man-a fact-who has no pulse.

  2. robB Says:

    The metaphor is clear–living dead ~ zombie.

  3. Karen Says:

    I had always heard that the left ventricular assist device was meant to be a bridge to heart transplant — in other words, a way to keep the patient alive until a donor heart becomes available. Frankly, I have wondered in the past why Cheney hadn’t already had a heart transplant.

    Anyway, what really struck me about the New York Times article on this was the paragraph: “Medicare will pay for the pump and for implanting it, which is $150,000 to $200,000, said Dr. Ranjit John, who directs the device program at the University of Minnesota Medical Center, Fairview.” Given what Cheney and his fellow “conservative” right-wing Republicans have done to undermine government, I would consider it very ironic if he is enrolled in Medicare and is having his care paid for by the government. I sure hope he isn’t saying Medicare is socialism!

    • JD Says:

      Too bad that Donald Berwick, Obama’s recess appointment to head Medicare and Medicaid, hasn’t had a chance to change the rules for Medicare yet. When he applies Dr. Ezekiel Emanuel’s complete lives system, Cheney would be denied the care needed to sustain his life. Health care is apparently an individual right, but not a right of the individual.

    • markbittner Says:

      I don’t know what Ezekiel Emanuel or Donald Berwick believe, but, as far as I’m concerned, their beliefs are completely beside the point. The moral position is that there be universal health care for everybody regardless of ability to pay. But the Republican party will never stand for it. They want health care to be treated as just another commodityan immoral position. So what we got is the most we’re going to get within the current mindset.

  4. shelley Says:

    The only good to come from Medicare paying for Cheney’s device is that precedence will be set for others to receive the same benefit.

    Did Cheney have a pulse previously? This man is evil personified.

  5. Donnie May Says:

    Dick Cheney was a heartless human being before the surgery. So is his wife. I heard an interview with her by Terry Gross on Fresh Air on public radio a few years ago. Mrs. Cheney showed her true colors: rude, full of hate, & downright mean.

    Mark, I have been wanting to write to you about the importance of medical insurance. In one of your posts you said that you had become a homeowner, but had not yet obtained medical insurance. Some friends of mine lost their home & almost all of their possessions due to the medical bills resulting from the wife’s breast cancer. She took her last breath lying in an old dilapidated camper given to them by other friends.

    I had a serious accident last fall in which I broke my leg. I had to have surgery, etc. I was in the hospital for 3 nights & 4 days. The hospital bill which did not include the orthopedic surgeon or the anesthesia exceeded the value of my house. This is not a large fancy hospital in a city. This is an average hospital in a pretty average town – around 50,000 people. Fortunately, I have medical insurance. So my part ended up being pretty reasonable.

    But what impressed me was the way the insurance company negotiated the bills. There were many items that they disputed & the hospital relented. If I hadn’t had the insurance company doing my bidding, I probably would have had to pay the full charges. I know one can hire an attorney & fight these things, but that could end up costing just as much plus all the stress!

    So if you haven’t already, please get some medical insurance.

    • markbittner Says:

      We’re aware of this. We think of it fairly often and I’m sure we’ll be doing something about it somewhere along the line. I believe the new law requires it. No?

  6. Margaret Says:

    There’s a type of insurance called Catastrophic. It doesn’t cover small routine visits to the doctor, but protects you from being financially devastated if you have a major illness or injury. It’s a really, really wise investment.

  7. Sarah Says:

    Mark, please get yourself medically insured ASAP. For as long as you are uninsured, you are a financial liability for your wife. Protect yourself from potential medical debt for her sake, if not also for your own. If you are self-employed, you might be able to deduct some of your insurance costs. Just avoid a certain health insurance company that is headquartered out of state. And no, I don’t work for a health insurance company!

    I don’t know much about long-term care insurance (LTCI), but you might consider looking into it. Though expensive, LTCI could help to defray the cost of a year or two of even more expensive assisted living ($35,000 + a year) or nursing care ($100,000 + a year) should you ever need it. Some expenses might be tax deductible. Health insurance policies do not cover the cost of long-term care and–I’m guessing here–I think Medicare picks up the tab only after you are down to your last ~$100,000 (e.g., your house).

    By the way, if Medicaid pays for your long-term care, the state will posthumously take your house and other assets to recover the money it had spent on you.

    I’d recently read somewhere that, through Wall Street investments, our medical expeditures help to supplement tax revenue to pay for services at home and abroad.

    No other country, bar one or two, does this. But it is what it is.

  8. Sarah Says:

    >> By the way, if Medicaid pays for your long-term care … <<

    Sorry, I'd meant to type Medicare.

    • Donnie May Says:

      Sarah, you were right the first time. It is Medicaid (not Medicare) that takes your house.

      Here’s how: Generally Medicare does not provide long term care benefits. However, it can cover up to 100 days in a Nursing Home under the “skilled nursing facility” benefit. Medicaid does provide long term care coverage. But to qualify for Medicaid you have to meet an income test & an asset test. You have to be low income with limited resources.

      Usually it works like this: After you have been in the Nursing Home your allotted 100 days, Medicare stops paying the bill. You have to start paying it yourself. If you have enough income (Social Security, pension benefits, etc.) to pay the bill then you pay it & your assets are left in tact.

      If your income is not high enough to cover the Nursing Home bill (for example you only receive Social Security) then you have to cover the rest of it by liquidating your assets. This is called “spending down” until you qualify for Medicaid. This means you have to exhaust most of your assets (cash, savings, investments, etc.) by paying your own Nursing Home bill from their proceeds until you are basically broke. Your home (assuming it is paid for) is about the only asset you are allowed to keep.

      At that point Medicaid kicks in & starts paying the part of the bill that you are unable to pay. However, Medicaid keeps a running tab on how much they pay. Upon your death your estate has to pay the Medicaid tab. This is called the “Medicaid Estate Recovery” program. Usually the only way the estate can pay the tab is to sell your home.

      The way this is enforced is through the probate system. All heirs (even those of a person who has never been on Medicaid) must obtain a “Medicaid Clearance” certificate showing that there are no outstanding liabilities to the Medicaid system before the decedent’s estate can be settled & any property transferred.

      Mark, I know what an odious task it is to look into & compare these things. And having said all of this, you would think I would have Long Term Care insurance, but I don’t. However, I have now convinced myself that I should. So I am going to bite the bullet & take on the odious task.

    • markbittner Says:

      The way I’ve always done things–or at least for the last thirty seven years–is this: I follow the path I’m on, and I take care of things when that path indicates it’s time. It’s always covered me. I don’t know any other way.

  9. Sarah Says:

    Mark, your path has always covered you because, for most of the last thirty seven years, you’ve been young, single, and (presumably) had good health and few assets. You’ve been lucky and thank god for that.

    I admire you for not living your life in fear and for not feeding the machine, but access to health care services is not a luxury; it’s something you may someday need. Even if you are a healthy 112 year old, a drunk driver or some other act of god can change everything. I think what has worked well in the past might not necessarily work as well in the future.

    You’re right about the new law; in 2012, everyone who does not have health insurance through an employer will be required to purchase it or pay a fine. As such, the foregoing is almost a moot point.

    • markbittner Says:

      As I said, it looks as though I’ll be getting health insurance in the not too distant future. But I have to say that I disagree with your first paragraph. The path has always covered me because that’s what the path does.

  10. Margaret Says:

    It’s one thing to follow your path, and it’s another thing to tempt your path, or dare your path…

    A mountain is a mountain, so we treat it like a mountain. Our human body is a (fragile, sometimes vulnberable) human body; so we take thought for everything that means.

    • markbittner Says:

      I don’t argue the finer points of this in public. It’s more delicate than that.

  11. Andrew Says:

    Hello Mark,

    I know this is off topic, and perhaps impossible for you to answer, but your progress reports are tantalizing. Have you any idea when your new book will be available? Any timetable for completion?

    Your blog is a real treasure trove, I appreciate your work.

    Andrew.

    • markbittner Says:

      It’s hard to say. At least two and a half more years of writing. Then it takes a year to get the book out. It seems like a long time, but then suddenly it’s done. I’m working hard on it. At no point in a day is it ever far from my mind. I have to say that I like the way that it’s developing. The time I’m taking–and it’s a real luxury nowadays to be able to write a book this way–is paying off. At some point I imagine I’ll make an excerpt available somewhere in some way.

  12. Diane Says:

    Mark, I understand what you mean by following the path completely. It’s also how I’ve done things. When plugged into it fully, it is magical how things work out. It is when we clutch and grab that things begin to slip away.

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