Health care reform is a huge debate in the U.S. right now. As Canadians who spent the last few years in France, Amynah and I are still grappling our way through the American system – learning the differences between HMOs and PPOs, and the complexities of private health insurance.
So far, our only direct experience with the medical system was last week, when we had our first appointment with Amynah’s new obstetrician. The contrast with France was astounding.
We had visited several different doctors in France – our GP, a specialist when I broke my arm, and the “gynecologue” to monitor Amynah’s pregnancy. In each case, the doctors in question had exactly zero staff. They took their own appointments, did their own paperwork, answered their own phones. And they were, without exception, very good at what they did.
When we showed up in our new doctor’s office it was a bit of a shock. There were three people behind the reception desk and a nurse’s aide we had to get through before seeing the doctor, who was accompanied by an intern and who handed us off to a nurse for the ultrasound.
This, in itself, was not too surprising – it’s a hospital-based practice, and not shockingly overstaffed when compared to a Canadian practice. Still, our insurance is paying for it all.
What did shock me was the feeling that we had walked onto a car lot. It’s a for-profit health system, operating in a legal system that allows for massive lawsuits. Which means that it is in the doctor’s interest to “sell” you on tests that will a) earn the practice money and b) further cover people’s butts if things go wrong.
In this case, the tests we were being sold were for inherited disorders. According to the papers we were given, the American Geneticists Association recommends that everyone be tested for these illnesses – impeccable family histories notwithstanding - at a cost of roughly $800 each.
The documents we were given threw up some scary numbers for the diseases “One in 150 women is a carrier” for Fragile X (which, incidentally, is far higher figure than I’ve seen online, leaving me to feel even more manipulated) was one number that was particularly emphasized. That the actual incidence of the disease was only one in 4,000 was barely mentioned at all. Amynah and I declined the tests, at which point we were forced to rethink our decision by having to sign a ominously-worded waiver absolving the doctors of liability for our choice.
All of which seemed designed to push prospective parents – nervous and overwhelmed as they are – to shell out money for tests that they probably do not need. Meaning the technicians, labs, doctors and pharma-companies are - 3,999 out of 4,000 – wasting their time with tests that needn’t be done, however profitable they might be. While those resources are being consumed, the parents-to-be are sitting on pins and needles and out of pocket to the tune of $2,400, money which might have gone to their child’s college fund.
Tuesday, September 29, 2009
Monday, September 28, 2009
Mountains and molehills
This weekend, friends of our from Amynah’s lab took us on a massive tour of Los Angeles, the only way that Los Angeles can be seen – by car. We covered some 130 miles (which is… errr… 200 km?).
The most interesting thing we saw (in the picture above), for me, was this dune in a park near Manhattan Beach, a ritzy part of town south of Santa Monica.
College and high school football is a huge - huge deal here. Roughly half the LA Times sports pages are dedicated to the sport.
This park, with its enormous sand dune, was used by a select group of athletes in the know. They would race up the unstable, mushy slope as a means of strengthening their calves and thigh muscles, the better to do battle with their meathead peers on the athletics field.
However, with the internet, word got out. Soon, athletes from all over Los Angeles were converging on the little park. And they brought their friends, their girlfriends, their cars, and their car stereos.
This picture has nothing to do with this post. This thing isn't a real island - it's manmade, built to hold an oil rig.
The local residents were somewhat discomfited by this invasion. The newcomers were loud, they stayed all hours, and their presence denied others the use of the park. Unavoidably, there were class and racial elements to the conflict – the locals were rich and mostly white, the invaders poor, and mostly black.
And so, the authorities solved the problem by putting up a fence, forbidding anyone the use of the dune.
I think all of this could have been avoided if people here just played hockey instead.
Friday, September 25, 2009
Yeah well... so's your mother.
The crowded fountain in the apartment courtyard
I suspect there are few places in the world better for people-watching than Los Angeles. The city is renowned for attracting the odd, off-kilter, and bizarre.
One of these is my landlord.
Our landlord was German who spend part of his early life not far from Strasbourg (he was the son of a factory manager posted to Lorraine in 1940, until the family suddenly had to leave in 1944. “We were refugees from the West,” he told us, seemingly expecting sympathy. No comment.) He now owns our building and at least one other in our neighbourhood, as well as a mysterious “business” in Chile.
He is rich as Croesus, and owns at least three identical Mercedes Benz (white, black and red). He wears a cowboy hat at all times, as well as a Bolero tie fashioned from some kind of animal horn. He wears two $15,000 watches, one on each arm – one is set to German time, the other to local time.
As a landlord, he’s not bad – the place is well maintained, and most of the initial problems we had moving in were dealt with expeditiously. Nonetheless, I am plotting against him.
Why? Well, the day we viewed the apartment, after chatting about eastern France (and glossing over what, precisely, his father’s affiliations were that earned him, at age 28, the strategically important position of manager of a steel mill in occupied territory during wartime), he asked where in Canada we were from. I told him Halifax.
“Oh, Halifax, I have been there!” he said.
“Great! Were you on vacation?” I asked, expecting polite noises about my hometown’s many charms.
“No, no. My friend was visiting, and he had a heart attack. I went there to visit him in the hospital,” he said.
“Oh, that’s too bad…” I began, but he interrupted me.
“Let me tell you something about Halifax. I’ve been to many countries all over the world…” he began. I began a smile, expecting that he would finish “and the people in Nova Scotia were by far the friendliest!”
Nope.
“… and the women in Halifax were the ugliest I’d ever seen. Really. The portrait of the Queen in the hospital was the best looking one I saw the whole time I was there.”
Now, Dear Readers, I would like to be able to report that at this point I drew myself up to my full height and launched into a furious defense of the womenfolk of my home province. But understand: we had not yet signed the lease. I had no home, Amynah really wanted the apartment, and this Stetson-wearing pseudo-cowboy held the key to my future comfort.
“Oh, well…” I smiled weakly, “I guess you were unlucky then.”
Forgive me. Though in my defense, I'm considering hiding a dead fish in one of his lovely cars.
Tuesday, September 22, 2009
A day at the beach. Well, an hour.
Venice beach and the beach of Santa Monica are relatively close to our new home, and so on Sunday we decided to take a trip to the seaside. Unfortunately, we left it far too late, arriving at the seaside at close to 4 PM. Even though that’s pretty late in the day for beach going, the roads around Venice Beach were choked with traffic – it took us 15 minutes to go through one light.
Parking was going to be impossible (and expensive - $12 minimum!) so we headed north a mile or two, to Santa Monica. For some reason, even though the two beaches are pretty much the exact same stretch of sand, Santa Monica was nearly abandoned when we arrived.
We didn’t stay long, and I wasn’t the least bit equipped to be on a beach (next time, I bring sandals) but it was interesting to see the differences between the two sections of coast. Venice Beach (what little we saw of it) is a refuge for bikers, hippies, and people with tattoos on their necks. The big event we saw there – other than the boardwalk lined with noisy bars and tables of junk jewelry and psychics’ stalls – was a massive drum circle on the sand, a throbbing mass of pot smoke, sweat, and whirling dreadlocks.
Further north, we crossed an invisible line in the sand onto the considerably more staid Santa Monica beach. It lacked a boardwalk – instead, it was lined with a grassy verge dotted with folks reading, and a bike path on which cyclists and rollerbladers competed for space. The big event on the sand here? It appeared to be an outdoor prayer meeting of a Santa Monica synagogue.
Monday, September 21, 2009
Notre Dame... again?
Some time ago I did a post on the fantastic pulpit in the Church of Notre Dame de Strasbourg - I mentioned, offhand, that on the equinox (I probably said solstice) the sun will shine through a particular pane of glass onto the carved crucifix. I've never seen it, but here's a video, of what it should look like tomorrow.
Thursday, September 17, 2009
Tales from the DMV
So, after sitting in the DMV for two hours, to register my car in California, that happy moment arrived when they called my number "B128 - counter 18." Clutching my heft of paperwork, I went 18-ward, arriving with a cheery "Hello!"
"Grunt," said Miss (Ms?) Counter 18.
I explained what I wanted, and she asked me what paper I had brought. I opened my folder, and presented her with the wonders within: a document from Homeland Security! Another document from Homeland Security! A document form Honda! A document from the dude outside who inspected the car! A document from Nova Scotia! A document from my new insurer! My license! My lease! My smog inspection certificate!
"Grunt," said Miss Counter 18, obviously rendered speechless by the splendour of my muniments.
She proceeded to thump away with some ill-humour at her computer which, judging by her repeated appeals to her coworkers, was not able to cope with the ineffable foreignness of my car. Judging by the sub-voce imprecations afterwards directed at her coworkers, their advice was not helpful.
At one point, one of her passing colleagues dropped by to offer a hand. As she explained the difficulties the mysterious stranger from the Great White North was posing to her database, he eyes lifted, first to me, and then to a point somewhere over my right shoulder. I stood still, worried that perhaps my cowlick was acting up again, perhaps assuming some obscene form on my head.
"Hey!" he suddenly yelled. "What are you writing?"
"Nothing," said a Russian-accented voice behind me (not my cowlick - phew!). "Just... something personal."
I turned. All of us in the DMV that morning turned, desperate as we were to counter the shattering ennui of waiting, waiting, without even some piped-in smooth jazz to alleviate the torment. The Russian was a big man, in a t-shirt with an airbrushed logo for a heavy metal band, clutching a pad of post-its and a pen to his chest, jaw thrust out defiantly.
"You were copying the eye test chart," said DMV guy.
"I was not. Besides, it's a free country," said the Russian.
"You can't do that. Go sit down over there," said the DMV guy.
"I can write what I want. You can't tell me what to do! It's a free country!" said the Russian.
The exchange continued like this, until a security guard finally came out and escorted the man off the premises. The last I heard of him, he was yelling "I'll sue! I'll sue!"
Disappointed, all of us in the DMV went back to inspecting those points in the middle-distance that had occupied our attention before. I looked up at the eye chart - it was suspended from the ceiling, about ten feet behind the counter where I stood. I could read it easily with my glasses on. I asked Miss Counter 18 where one normally had to stand to take the eye test.
"Right where you are," she said, as she entered my address in her computer with extraordinary viciousness.
I fell silent. The Russian had been standing about 20 feet behind me - three times further than he needed to be to pass the test. If he was copying the numbers from there without aid of a telescope, why did he need to copy them at all?
"Grunt," said Miss (Ms?) Counter 18.
I explained what I wanted, and she asked me what paper I had brought. I opened my folder, and presented her with the wonders within: a document from Homeland Security! Another document from Homeland Security! A document form Honda! A document from the dude outside who inspected the car! A document from Nova Scotia! A document from my new insurer! My license! My lease! My smog inspection certificate!
"Grunt," said Miss Counter 18, obviously rendered speechless by the splendour of my muniments.
She proceeded to thump away with some ill-humour at her computer which, judging by her repeated appeals to her coworkers, was not able to cope with the ineffable foreignness of my car. Judging by the sub-voce imprecations afterwards directed at her coworkers, their advice was not helpful.
At one point, one of her passing colleagues dropped by to offer a hand. As she explained the difficulties the mysterious stranger from the Great White North was posing to her database, he eyes lifted, first to me, and then to a point somewhere over my right shoulder. I stood still, worried that perhaps my cowlick was acting up again, perhaps assuming some obscene form on my head.
"Hey!" he suddenly yelled. "What are you writing?"
"Nothing," said a Russian-accented voice behind me (not my cowlick - phew!). "Just... something personal."
I turned. All of us in the DMV that morning turned, desperate as we were to counter the shattering ennui of waiting, waiting, without even some piped-in smooth jazz to alleviate the torment. The Russian was a big man, in a t-shirt with an airbrushed logo for a heavy metal band, clutching a pad of post-its and a pen to his chest, jaw thrust out defiantly.
"You were copying the eye test chart," said DMV guy.
"I was not. Besides, it's a free country," said the Russian.
"You can't do that. Go sit down over there," said the DMV guy.
"I can write what I want. You can't tell me what to do! It's a free country!" said the Russian.
The exchange continued like this, until a security guard finally came out and escorted the man off the premises. The last I heard of him, he was yelling "I'll sue! I'll sue!"
Disappointed, all of us in the DMV went back to inspecting those points in the middle-distance that had occupied our attention before. I looked up at the eye chart - it was suspended from the ceiling, about ten feet behind the counter where I stood. I could read it easily with my glasses on. I asked Miss Counter 18 where one normally had to stand to take the eye test.
"Right where you are," she said, as she entered my address in her computer with extraordinary viciousness.
I fell silent. The Russian had been standing about 20 feet behind me - three times further than he needed to be to pass the test. If he was copying the numbers from there without aid of a telescope, why did he need to copy them at all?
Wednesday, September 16, 2009
Me versus Substance X.
When you’re a married couple planning on driving across a Continent in a two-door Civic, what you take with you can become a matter of friction. Our car was packed to the brim, and virtually nothing was easily accessible. And, as is usually the case, it was always theother person’s stuff that was superfluous: if Amynah wanted access to her other pair of shoes, for instance, it would be my guitar that would be in the way. If I was attempting to squeeze in the tape recorder I use for interviews, one of Amynah’s superannuated pharmacology textbooks would be clogging the box.
One item that caused a certain amount of stress was my camping gear. "Why do we need a gas stove? Why do you own two hatchets?* What use for a mosquito net hat are you going to have?" asked Amynah, as I grunted and cursed, trying to squeeze these items into my bag.
As it turns out, plenty. We didn’t have power on the first day we lived here, and so our tea was brewed over the blue flame of my camp stove on our balcony, and the two flashlights I packed came in handy in the dark.
The upstairs bathroom has a skylight that has, over the years, been encrusted with a black coating of Substance X. Personally, I believe Substance X to be a combination of shower steam and smog residue, baked on the interior of the glass by the sun. Amynah, on the other hand, was convinced that it was a toxic mould of some sort. Given that she is relentless, pregnant, and able to conjure up all sorts of horrific scenarios as to what could happen if she or the baby inhaled Substance X (“We could have some sort of lizard baby, with two tails. You don’t want a two-tailed lizard baby do you?”) I was induced to clamber up onto the bathroom counter, stick my head into the skylight, and investigate.
Skylight, with Substance X
A swipe with a sponge did nothing, but when I poked at it with my jack knife (thanks Yann!) some flakes came loose – which I immediately inhaled as they fell on my upturned face. This was not going to be pleasant.
Fortunately, Amynah had brought home a filter mask from her lab for the job, but that did nothing for my eyes (not to mention my precious, precious hair**). Whatever Substance X was, I didn’t believe it was toxic, but on the other hand, I didn’t know it wasn’t.
Suddenly, a flash of brilliance. I would wear my mosquito-net hat, and the filter mask. Not only would it prevent me from turned into a reptilian monstrosity, but I would also be able to justify having carted the damned thing 9000 km in the first place.
Yet somehow, when I summoned Amynah to the bathroom to deliver a triumphant “I told you so!” all she could do was laugh, and insist I post this photo on the blog.
* Why do I have two hatchets?
** I recently got my first LA haircut. The barber referred to my hair as "strong" as he rubbed the cramps out of his scissor hand. If you're going to charge me twenty bucks for a 15 minute cut, you better work for it buddy.
One item that caused a certain amount of stress was my camping gear. "Why do we need a gas stove? Why do you own two hatchets?* What use for a mosquito net hat are you going to have?" asked Amynah, as I grunted and cursed, trying to squeeze these items into my bag.
As it turns out, plenty. We didn’t have power on the first day we lived here, and so our tea was brewed over the blue flame of my camp stove on our balcony, and the two flashlights I packed came in handy in the dark.
The upstairs bathroom has a skylight that has, over the years, been encrusted with a black coating of Substance X. Personally, I believe Substance X to be a combination of shower steam and smog residue, baked on the interior of the glass by the sun. Amynah, on the other hand, was convinced that it was a toxic mould of some sort. Given that she is relentless, pregnant, and able to conjure up all sorts of horrific scenarios as to what could happen if she or the baby inhaled Substance X (“We could have some sort of lizard baby, with two tails. You don’t want a two-tailed lizard baby do you?”) I was induced to clamber up onto the bathroom counter, stick my head into the skylight, and investigate.
Skylight, with Substance X
A swipe with a sponge did nothing, but when I poked at it with my jack knife (thanks Yann!) some flakes came loose – which I immediately inhaled as they fell on my upturned face. This was not going to be pleasant.
Fortunately, Amynah had brought home a filter mask from her lab for the job, but that did nothing for my eyes (not to mention my precious, precious hair**). Whatever Substance X was, I didn’t believe it was toxic, but on the other hand, I didn’t know it wasn’t.
Suddenly, a flash of brilliance. I would wear my mosquito-net hat, and the filter mask. Not only would it prevent me from turned into a reptilian monstrosity, but I would also be able to justify having carted the damned thing 9000 km in the first place.
Yet somehow, when I summoned Amynah to the bathroom to deliver a triumphant “I told you so!” all she could do was laugh, and insist I post this photo on the blog.
* Why do I have two hatchets?
** I recently got my first LA haircut. The barber referred to my hair as "strong" as he rubbed the cramps out of his scissor hand. If you're going to charge me twenty bucks for a 15 minute cut, you better work for it buddy.
Sunday, September 13, 2009
Movietown
Now that Amynah and I are settled, we're making some small efforts to exploring our neighbourhood. Before moving here, I knew nothing about L.A. at all, beyond what I'd seen in the movies (almost none of which was flattering). I'd never heard of Westwood, but once we let our friends and family know our address, everyone hopped on to Google Maps.
"Oh! You're near where Nancy Reagan lives!" said Amynah's Mom, inexplicably enthused by the idea.
"You're not too far from Hollywood," my Dad informed me.
"You're really close to the Playboy Mansion! It's like, four miles from you! Seriously!" said an excited friend, seemingly expecting me to be so electrified by the news as to drop the phone that instant and race there that instant. To save him embarrassment, I won't tell anyone here that that was Tim.
Tim also found out that in addition to our proximity to UCLA, our part of town is apparently well known for its historic theatres (I think historic in this context means "old" not in the sense that "Lincoln was shot there." And "old" means "pre-1960" not "around when Lincoln was shot." I'm still making adjustments here people, bear with me). They're certainly local landmarks, and Amynah and I fully intend to visit one for a matinée as soon as possible. They're certainly shinier than my previous city's landmarks.
Friday, September 11, 2009
Home tour
From the Mayo Clinic Guide to a Healthy Pregnancy, week 25-28: "You will be busy buying final supplies, finishing your baby's room...." Here you go baby. The finest empty boxes and plastic bags money can buy.
We're home, and I have Internet! Life is grand. Now that we have sufficient furniture to sleep, eat and read, I present you with our life so far.
Our bedroom.
We live in an area called Westwood, which is very close to UCLA - close enough that Amynah can walk. We're very (by local standards) close to Santa Monica, and the Pacific, though we haven't yet visited. Being this close to the ocean means its a little cooler here than other parts of the city, and we're nowhere near the wildfires.
The main floor, kitchen, dining area and parlour area
Our immediate neighbourhood is pretty well appointed: all the major amenities are here. There's even a bagel shop, and a French bakery (staffed by une vrai française. Neither matches up to Fairmount/Christian standards, but I'll take what little bits of home I can.
I will write more later, but now I desperately need to catch up on the work that somehow slid over the previous month's epic journey.
Friday, September 04, 2009
Los Angeles: The beginning of the end of the beginning
At some point, I am going to do a proper post with photos, amusing anecdotes and the tales of woe and suffering that seem to please all you readers so much, but at the moment, I'm going to stick with a "I'm still alive post."
In effect, we arrived in Los Angleles on Sunday. Since then, we have found an apartment, Amynah got a Social Security number, we've transferred our meagre belongings to our place, I've ordered, but not yet received, phone and internet service, and we've done a little bit of furniture shopping.
Amynah's lab has been astounded that we've accomplished all that we have as quickly as we have, but for me, it's been endless: we have been living out of our suicases since July 31. I want my own bed, in my own place, and to have the choice of clothes that aren't wrinkled from weeks of being crammed in a bag.
The ferocious heat isn't helping my temperament either - the temperature is supposed to reach 34 degrees celsius today. The sun is my enemy. My car is covered with ash from the wildfires (which are fortunately nowhere close to where we live) - the last two nights, it was like the sun had set two hours early because of the smoke. Or maybe that's just LA's famous smog - I haven't had time to ask.
Once I have some semblance of a normal life, I'm sure my humour will improve. So far, the few people we've asked for help have been incredibly generous - our apartment is full of borrowed camping equipment, dishes and food. Amynah's relatives have been very generous with their hospitality. And our apartment is amazing - two levels, two bedrooms, a balcony, parking, quiet neighbourhood near UCLA. So at some point, our lives will be much better, and easier.
The end is in sight, but it isn't nearly close enough.
In effect, we arrived in Los Angleles on Sunday. Since then, we have found an apartment, Amynah got a Social Security number, we've transferred our meagre belongings to our place, I've ordered, but not yet received, phone and internet service, and we've done a little bit of furniture shopping.
Amynah's lab has been astounded that we've accomplished all that we have as quickly as we have, but for me, it's been endless: we have been living out of our suicases since July 31. I want my own bed, in my own place, and to have the choice of clothes that aren't wrinkled from weeks of being crammed in a bag.
The ferocious heat isn't helping my temperament either - the temperature is supposed to reach 34 degrees celsius today. The sun is my enemy. My car is covered with ash from the wildfires (which are fortunately nowhere close to where we live) - the last two nights, it was like the sun had set two hours early because of the smoke. Or maybe that's just LA's famous smog - I haven't had time to ask.
Once I have some semblance of a normal life, I'm sure my humour will improve. So far, the few people we've asked for help have been incredibly generous - our apartment is full of borrowed camping equipment, dishes and food. Amynah's relatives have been very generous with their hospitality. And our apartment is amazing - two levels, two bedrooms, a balcony, parking, quiet neighbourhood near UCLA. So at some point, our lives will be much better, and easier.
The end is in sight, but it isn't nearly close enough.
Subscribe to:
Posts (Atom)