Early up and the day is started. After my cup of coffee, it is time to catch up on email. I have friends in far flung places. God bless email. It keeps us together and up to date on events in our lives.

Today, I get an email from an ecard website. I love this website. The cards there are well drawn, animated with music to set the mood. There are three animated Christmas ecards...all good. The cards are previewed. I arrange for them to be delivered just before Christmas. The ecards are in addition to the paper cards I've all ready sent out.

The old fashioned ecard gets me remembering my childhood. This mental link is called association. In the ecard, some of the gifts under the Christmas tree are similar to those I had as a child....or wanted to get but never got.

In memory, I am a child again, wandering around the old neighborhood. There are two neighborhoods....one for winter and one for summer, as my father had a little cottage out at the lake. It was there I learned to swim. I think I spent the entire summer in my bathing suit and loved it. Those are happy memories. I hear my mother say about such memories: "Memories that bless and burn". Yes. They sure do. Today, they are blessing.

Then, I remember that I was free to wander in and out of other people's houses. People did not lock doors then. I was curious and friendly. I said hello to my neighbors. Some of them were the parents of my playmates, but others were not. I remember going into a cottage that had a little sun porch. By little, I mean really little. It was just big enough for a daybed...which was on the long wall. Hanging in the window, was a spider plant with little spider plants growing out of the pot. It was like a green waterfall. The lady told me the name of the plant. I was delighted to see the plant sway in the breeze that was coming through the open window. Also in memory, my lungs filled with fresh air and the sound of the waves on the beach. You can't beat that experience.

A winter memory : back in the city. Next door lived Mama Young. She was an overweight woman . Her children were grown. Their names were Bob and Marie. I remember that Mama Young had a substantial rocking chair that she positioned facing the street. From her station on the rocking chair, she could watch the street. She would watch and rock. I came to visit. She gave me a dust cloth and asked me to dust the furniture...which I did. That was not remarkable for the times. In her dining room, was a matched set of furniture. There was a sideboard or credenza...placed in the same place that every home in the neighborhood placed their credenza: on the short wall . She had a display of fruit in a bowl on the sideboard that looked delicious. When no one was looking, I picked up a piece of fruit and bit it. It was wax. Oh Oh....I put the fruit back in the bowl...teeth marks down.

Mama Young's son, Bob came home from the war (world war 2). All the neighborhood kids were so excited to have a real hero come home. What could We do to show our welcome? What materials do children have for the task? Chalk. There must have been five of us who took chalk and drew all over the sidewalk and the street to welcome Bob home. I think We also drew on the cement step to the front door. I don't remember what the reaction was to our...probably messy....welcome home .

One sad day, Mama Young died. There was a reception in the house for her. Relatives and neighbors came in to pay their respect. The neighborhood children wanted to show respect, too. We went into the empty lot next door to my house and picked wildflowers. They were put in a glass with water. Solemnly, they were presented to Bob and Marie. Our flowers were placed with the other expensive and store bought flowers...in a place of honor.

In spite of the wind and the rain, I am looking forward to this day. I promised myself that I would go to the movies. Today is senior day. That means a price cut. Suddenly from outside, I hear a big boom. What in the world is that? It could be a traffic accident, or an airplane breaking the sound barrier. It could be a backhoe dropping a load. It certainly made a lot of noise. Looking out the window, I see nothing.
I am still in my pajamas. There is a knock at the door. It is my neighbor, Butch. He asks me to come outside and have a look. With jacket tossed over PJ's, I follow him outside, around the garage. Oh my gosh! Half of a maple tree has fallen between our two houses. It has taken down Butch's gutters and my gutters. It forced branches in the roof of my garage. It swiped Burtch's antennae off his mast and bent the mast. Butch reports that the pole is four feet in the ground, set in concrete and the hollow pipe is also filled with concrete. The force of the tree falling has made the mast list about 15 degrees. That is a lot of force. Butch says that the mast took the brunt of the falling tree. If it wasn't there, there would be a lot more damage to his house.
Back into the house I go. Get dressed. Grab camera. Take a lot of photos in the wind gusts and pouring rain. Drive to the photoshop to get the photos developed. Meanwhile, a public works crew is here. I had called them earlier to report the downed city tree.
There is lots of noise for at least an hour. The crew take the limb down. It is as big as a tree trunk and about half the volume of the tree. They cut up the tree limbs and take them away.
The backhoe also takes out my gutter downspout. My wire fence is bent and....could it be? My weather vane is gone. When the crew pulled branches off my roof, they also pulled the weather vane off. Where is it? I check the ground all over. It is no where to be found.
The back yard has branches. The crew goes into the backyard to get those branches. In the process, they pull up a newly planted pear tree and take it away. It must have looked like just one more branch to them. I go to the movies and forget everything for a while.
That was yesterday. Today, my neighbor and I compose a letter to the city informing them of the damage. I enclose the photographs. Butch calls a roof man and a gutter man. We will get estimates and forward the estimates to the city. I am sure that our claim will be honored. We will be back in business in no time at all.

The movie was titled, "Last Chance Harvey" with Dustin Hoffman playing Harvey. It's a cute movie....not destined to be an ageless classic. However, I caught a premise in the movie. Harvey was at loose ends. He had time to attend his daughter's wedding. Harvey was let go from his company. Harvey looks like a loser in the beginning of the movie. He really wants his job back. At the end of the movie, his boss (or agent?) asks him to come back. They had hired a replacement for Harvey. The new guy couldn't do the job. In the beginning of the movie, Harvey would have grabbed the first plane and went back to his job of composing advertising jingles. He would have come on his knees if He had to. At the end of the movie, Harvey tells the agent to shove it.

Scene two: Richard is working at SCM Corporation. It's a stressful job that requires competency. Over time, Richard and his colleagues become more and more proficient at their programming jobs. Over time, they get raises. Over time, administration notes that these guys are costing the company money. They find a way to let one man go. Richard and his colleagues watch the office politics at work. Administration hires a new programmer at a lower pay rate. Never mind that everyone works like donkeys. There were times when my husband worked around the clock to get the job done. So did the other men. They worked hard and earned their salaries. Never mind that the Supreme Court has ruled that this is discrimination on the basis of age. Never mind that. It happens all the time and it has happened to me several times. Anyways, the new man is now working at SCM. It is quickly shown that He can't cut it. He is slow and inexperienced. Administration determines that this new guy has a job that is too much for him. So, they hire a second man to help the first one.
Now the company has two men that are doing the work that one man did earlier. It took money and company resources to hire and train the new employees. Wouldn't it have been better to just keep the first employee, pay him his worth and trust in his efficiency and competency?

Scene three: I am working at a major insurance company. I am a technical specialist. All the people in my department are very competent at their job ...which is loss control. We have a lot of freedom to map out our own days. We have to meet deadlines for timeliness and for proficiency. Those that were goof offs, have been let go. There is a salary scale that supposedly is fair to all. A quick talk to my colleagues and I learn that none of us have reached the top of the pay scale...even those with many more years with the company. I note that this is a red flag. This is a wonderful company to work for. I put in extra hours willingly. So do my colleagues. The company announces that the company is going paperless. We are all trained on pen top computers. This makes sense, as insurance forms are standardized, so We should be able to input the information electronically. There is a learning curve. It is hard to see the screen when the sun is on it. It is difficult to back up when I find something that should be noted on a different page of the form. Over time, our proficiency rises.
Then, some bean counter in home office decides that loss control is very expensive. They have spent a lot of money purchasing pen top computers and training the staff. They solve the cost problem by closing down our department. Only a few top administrators can find a job in other departments. Some women take positions in claims processing...which doesn't pay the same salary as a technical specialist. We went to school to get certified. Claims processing is clerical.
The best salary I ever earned, was the last year that I worked in insurance. I hated to leave the company. I retired 5 years earlier than I had planned. As I am cleaning out my desk, I see advertisements for new hires in a different department. Their starting salary is the same as my ending salary.

We did not have good weather for Melanie and Dan's visit. However, family can make good experiences whatever the weather. It was Melanie's birthday. We went to a good restaurant. Her number one son and number 3 son came to celebrate with their mom. Chris' girlfriend, Marge came too. We filled up the table, ate good food and wine and congratulated Melanie. There was another feast at my house on another day. Mostly, with all that cold and rain, We stayed in, watched movies, went through old scrap books, re-read old letters. It was enough that We were together, if only for a little while.

They are now back in Australia and it is time to get the property ready for winter. Tasks that I did not do in the spring, are staring me in the face. Too soon, the leaves will require raking. I am reluctant to do all this yard work by myself, although I am capable of doing it.

Our social service Department has a program called "Rent a Kid"....or is it "Hire a Kid"? Anyways, I signed up for this program. The first mother that called me was some experience. She is the typical helicopter parent. (she hovers) Her son, my potential yard work partner, has never held a job of any kind. He is 17 years old. His mother said that He will be coming with a friend to keep him company....and she told me what she would be charging me....which is more than double what I intended to pay. You can imagine that the deal fell through. First of all, a young man seventeen does not need his mother to apply for his job. Second of all, a paid position pretty much precludes having a friend around to talk to while working. ...or am I that much out of date?

I called the program director back and explained the above. Then, I told him that a young man with no work experience will not be working efficiently. I could just call a landscape company and they will be in and out in half a day with all the yard maintenance done. Even if I pay them more, they will do the job a lot faster than a high school kid. Therefore, I will not be paying any more than minimum wage.

A few days later, the phone rings. It is another mother. Her son is 13 years old, big for his age and is applying for the job. We arrange to meet. This is a good family. We agree to $6 an hour. Then, I get the request that Stephen would like to have his friend help him. I don't know what to say. The mother says that I don't have to pay the helper, but Stephen would enjoy the work more if He had a friend along. I know that this generation is very social. They live with a cell phone attached to their ear. (Stephen has one...so does his friend). I have the choice of forbidding Stephen to bring his friend or to let him bring along his friend. The difference from the first applicant is the age. These boys are 13 years old. I regret saying OK, even as the words leave my mouth.

On the appointed day, Stephen and his friend, Alex appear ready to work. Alex is a small 13 year old. Stephen is man size. They get right to work edging my sidewalk. Over several days, they put down stone blocks to continue the walkway to the curb. They rake leaves. The two work well together, so I tell Alex that He is getting paid, too. For a 13 year old to get a check for $18 is a fortune. They will be spending their money on games.....Stephen has to get his x box fixed. I loved seeing the light in their eyes.

Then, the mother tells me the story about Stephen's helper. He and his two siblings are adopted from Russia. Alex has come from an alcoholic situation. He has malnutrition. His teeth are poor. Apparently, the state took the children away....or they were abandoned and neglected. No wonder Alex is small. He's been hungry. Alex's new mother tells me that although they had very little, the ladies at the orphanage loved the children. When she picked up the three, the workers stood at the door with tears in their eyes. The children never looked back. On the train, all they had to eat was tea and bread. They were so hungry that they tore open the sugar packets meant for coffee and ate them.

I fell in love with Alex...loved his inquisitiveness, learning about all things American. He was confused that I have 2 houses. How come I don't live in the house they are working on? Both boys are rewarded with their checks and root beer (their request). Working makes a fella thirsty.

The phone rang. It was my daughter, calling me from Arizona to let me know that she and her husband have arrived safely. They flew up from Australia. Her youngest son lives in Tucson Arizona. That was their first stop. After traveling over 24 hours on a plane, they will spend the next day visiting the Grand Canyon and then, Tombstone Arizona. If I flew 24 hours on a plane, I would want my first day to be a day of rest with my feet up, drink in hand.

I could tell that she was excited to see her youngest son and his wife...and probably glad to get off that plane. She will call me every night to tell me of the day's adventures and I probably will write about them here.

The allotment is only four days to tour around Arizona, then in a car for a long drive to the northeast to see more family.

E mail from J. H.: I'm not certain that this recessionary period is the best time to introduce an expensive revamping of the health system in this country, but there is little doubt that a simgle-payer government-run system is the way to go. The article below (from today's LA Times) is a good and I think fair comparison of the Canadian system with our own. I only wish that more citizens of our country were able to open their eyes and see what's really going on in the health care world and be less tied down by their ideologies.

A CANADIAN DOCTOR DIAGNOSES U.S. HEALTHCARE

The caricature of 'socialized medicine' is used by corporate interests to confuse Americans and maintain their bottom lines instead of patients' health.

by Michael M. Rachlis August 3, 2009

Universal health insurance is on the American policy agenda for the fifth time since World War 11. In the 1960s, the U.S. chose public coverage for only the elderly and the very poor, while Canada opted for a universal program for hospitals and physician's' services. As a policy analyst, I know there are lessons to be learned from studying the effect of different approaches in similar jurisdictions. But, as a Canadian with lots of American friends and relatives, I am saddened that Americans seem incapable of learning them.

Our countries are joined at the hip. We peacefully share a continent, a British heritage of representative government and now ownership of GM. And, until 50 years ago, we had similar health systems, healthcare costs and vital statistics.

The U.S. and Canada's different health insurance decisions make up the world's largest health policy experiment. And the results?

On coverage, all Canadians have insurance for hospital and physician services. There are no deductibles or co-pays. Most provinces also provide coverage for programs for home care, long-term care, pharmaceuticals and durable medical equipment, although there are co-pays.

On the U.S. side, 46 million people have no insurance, millions are under insured and healthcare bills bankrupt more than 1 million Americans every year.

Lesson No. 1: A single-payer system would eliminate most U.S. coverage problems.

On costs, Canada spends 10% of its economy on healthcare: the U.S. spends 16%. The extra 6% of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. Canadians don't need thousands of actuaries to set premiums or thousands of lawyers to deny care. Even the U.S. Medicare program has 80% to 90% lower administrative costs than private Medicare Advantage policies. And providers and suppliers can't charge as much when they have to deal with a single payer.

Lessons No. 2 and 3: Single-payer systems reduce duplicative administrative costs and can negotiate lower prices.

Because most of the difference in spending is for non-patient care, Canadians actually get more of most services. We see the doctor more often and take more drugs. We even have more lung transplant surgery. We do get less heart surgery, but not so much less that we are any more likely to die of heart attacks. And we now live nearly three years longer, and our infant mortality is 20% lower.

Lesson No.4: A single-payer plans can deliver the goods because their funding goes to services, not overhead.

The Canadian system does have its problems, and these also provide important lessons. Notwithstanding a few well-publicized and misleading cases, Canadians needing urgent care get immediate treatment. But we do wait too long for much elective care, including appointments with family doctors and specialists and selected surgical procedures. We also do a poor job managing chronic disease.

However, according to the New York-based Commonwealth Fund, both the American and the Canadian systems fare badly in these areas. In fact,an April U.S. Government Accountability Office report noted that U.S. emergency room wait times have increased, and patients who should be seen immediately are now waiting an average of 28 minutes. The GAO has also raised concerns about two to four-month waiting times for mammograms.

On closer examination, most of these problems have little to do with public insurance or even overall resources. Despite the delays, the GAO said there is enough mammogram capacity.

These problems are largely caused by our shared politico-cultural barriers to quality of care. In 19th century North America, doctors waged a campaign against quacks and snake-oil salesmen and attained a legislative monopoly on medical practice. In return, they promised to set and enforce standards of practice. By and large, it didn't happen. And perverse incentives like fee-for-service make things even worse.

Using techniques like those championed by the Boston-based institute for Healthcare Improvement, providers can eliminate most delays. In Hamilton, Ontario, 17 psychiatrists have linked up with 100 family doctors and 80 social workers to offer some of the world's best access to mental health services. And in Toronto, simple process improvements mean you can now get your hip assessed in one week and get a new one, if you need it, within a month.

Lesson No. 5: Canadian healthcare delivery problems have nothing to do with our single-payer system and can be fixed by re-engineering for quality.

U.S. health policy would be miles ahead if policymakers could learn these lessons. But they seem less interested in Canada's, or any other nation's experience than ever. Why?

American democracy runs on money. Pharmaceutical and insurance companies have the fuel. Analysts see hundreds of billions of premiums wasted on overhead that could fund care for the uninsured. But industry executives and shareholders see bonuses and dividends.

Compounding the confusion is traditional American ignorance of what happens north of the border, which makes it easy to mislead people. Boilerplate anti-government rhetoric does the same. The U.S. media, legislators and even presidents have claimed that our "socialized" system doesn't let us choose our own doctors. In fact, Canadians have free choice of physicians. It's Americans these days who are restricted to "in-plan" doctors.

Unfortunately, many Americans won't get to hear the straight goods because vested interests are promoting a caricature of the Canadian experience.

(Michael M. Rachlis is a physician, Health policy analyst and author in Toronto.)

email from Melanie: As you know, I don't really like to get into political debates. I figure - vote with your conscience and it's no one else's business, but, as you know, health care availability and affordability for all is an especially important issue to me, especially since I have seen my sons suffer without it.

Someone posted this essay in Facebook, and it says a lot of what I think when people start shouting "socialism" in the USA. They use the word "socialism" or "socialist" like it's a dirty word. I really think that those people don't understand what it really means. But this guy does (for the most part.):

Here is a post passed on from Carl Wlodarczyk (Denver, CO), who wrote:

This morning I was awoken by my alarm clock powered by electricity generated by the public power monopoly regulated by the US Department of Energy. I then took a shower in the clean water provided by the municipal water utility. After that, I turned on the TV to one of the FCC regulated channels to see what the national weather service of the National Oceanographic and Atmospheric Administration determined the weather was going to be like using satellites designed, built, and launched by the National Aeronautics and Space Administration. I watched this while eating my breakfast of US Department of Agriculture inspected food and taking the drugs which have been determined as safe by the Food and Drug Administration.

At the appropriate time as regulated by the US congress and kept accurate by the National Institute of Standards and Technology and the US Naval Observatory, I get into my national Highway Traffic Safety Administration approved automobile and set out to work on the roads build by the local, state, and federal departments of transportation, possibly stopping to purchase additional fuel of a quality level determined by the Environmental Protection Agency, using legal tender issued by the Federal Reserve Bank. On the way out the door I deposit any mail I have to be sent out via the US Postal Service and drop the kids off at the public school.

After spending another day not being maimed or killed at work thanks to the workplace regulations imposed by the Department of Labor and the Occupational Safety and Health Administration, enjoying another two meals which again do not kill me because of the USDA, I drive my NHTSA car back home on the DOT roads, to my house which has not burned down in my absence because of the state and local building codes and fire marshal's inspection, and which has not been plundered of all its valuable thanks to the local police department.

I then log on to the internet which was developed by the Defense Advanced Research Projects Administration and post on freerepublic.com and Fox news forums about how SOCIALISM in medicine is BAD because the government can't do anything right.

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With the exception of the Federal Reserve Bank, which is a private banking consortium, I have to agree. It's too bad people are so controlled by scaremongering.