Saturday, we took Boston up skiing for his first time ever. I must say that I was impressed with his endurance, as he probably could have skied all day long if we'd let him. He was pretty upset when the resort closed.
We went up with Jenny's family to Snowbasin where kids under 6 ski for free (if only the same rules applied for airlines, no?). The night before we managed to find some little skis and boots at Pedersen's to rent for $10, so not a bad deal at all. We got up there first thing and got him on the lift up Little Cat shortly thereafter. At first, he was pretty tentative. I put him between my legs and let him get the feel of the snow. I showed him how to make a wedge and then Grandpa Ted helped us with a technique where we put the tip of our pole on the edgie-wedgie (the rubber band dealie that holds the tips together). This created a little pressure that forced the skis into a wedge.
By the end of the day, Boston was really good at making a pizza with his legs. Although he never really picked up on turning (you try explaining to a 2 1/2 year old the application of pressure on the right leg causes a left turn), he got pretty proficient at stopping and speed control. We encouraged him to "Stop the train", at which point he would force his wedge out and stop. It was pretty fun to watch.
He only got away from us one time. Jenny was helping him out and he started going pretty fast and got around her. He was panicked so yelling at him to stop the train wasn't working. He started heading straight for a pole where the Wildcat lift queue was, managed to miss the pole, but caught some air off the drift around the pole and crashed pretty hard. I thought he would be done, but after shedding a few tears, he was back up and we were headed down the mountain.
He still has a ways to go. He was constantly distracted by the people and equipment around him. He got a little scared when a snow cat drove by. When he would fall, instead of crying, he just picked up some snow and ate it as he cruised down the hill. He really had a good time, though. It's exciting for me that he enjoyed it that much. I've always looked forward to skiing with my kids. I hope that starting him young will instill a love of skiing and it will be something that he enjoys throughout his life as much as I do.
It was also Jenny's first time up in two winters. She was pregnant with Jae last year, so she enjoyed getting up and taking some runs. I give her credit for sticking it out because her boots were killing her all day and we didn't get any adult runs in until the end of the day. I'm glad I married a girl who loves to ski, too.
Monday, February 25, 2008
Thursday, February 14, 2008
Happy Valentines Day, Jenny
Jenny, this one's for you. As for the rest of you...
Warning: The following posts contains schmaltzy romantic talk. Proceed at your own risk. Blogger discretion is advised.
I'm not very good at this kind of thing. Hopefully, you know this and understand that I try. It's been an amazing 5, almost 6 years; 7 really, if you count the year we dated. I think back on how far we've come together and I know I couldn't have done it without you. We have two amazing kids and you are an amazing mother. I don't know how you put up with them all the time, or me for that matter. I know that you have all the gifts to be the nurturer, comforter, mother that they need. You are the spiritual compass of the family, always getting us back on track. I know that I can lean on you, even though I try to be the strong one and do it on my own. I know you're there if I need you, though. I don't express my love in enough ways that I think you comprehend how much I do love you. I don't want to imagine life without you and I look forward to spending eternity with you. You are my heart.
I love you, Jenny.
Warning: The following posts contains schmaltzy romantic talk. Proceed at your own risk. Blogger discretion is advised.
I'm not very good at this kind of thing. Hopefully, you know this and understand that I try. It's been an amazing 5, almost 6 years; 7 really, if you count the year we dated. I think back on how far we've come together and I know I couldn't have done it without you. We have two amazing kids and you are an amazing mother. I don't know how you put up with them all the time, or me for that matter. I know that you have all the gifts to be the nurturer, comforter, mother that they need. You are the spiritual compass of the family, always getting us back on track. I know that I can lean on you, even though I try to be the strong one and do it on my own. I know you're there if I need you, though. I don't express my love in enough ways that I think you comprehend how much I do love you. I don't want to imagine life without you and I look forward to spending eternity with you. You are my heart.
I love you, Jenny.
Monday, February 11, 2008
Ramblings of a Clinic Administrator
Foreword: This post was inspired by a message board discussion. I'm not a big politico and don't normally dabble in this arena, but I do feel strongly about healthcare as it is my livelihood. If you're interested, go ahead and read and let me know what you think. If not, skip it.
As a manager of medical clinics, I hope that I have a good grasp on many of the issues that have been discussed on this thread. I'll admit I'm not nearly as informed as some, but I think a lot about universal healthcare and have come to the following conclusions, take them for what they're worth:
1) Things on paper look a lot better than they do in application. I like to use HIPAA as an example. It seems to make sense that you would want to protect personal health information and I believe most clinics and hospitals took reasonable steps to do so. I'll bet few people on the board know that the impetus behind HIPAA was the "portability" of healthcare insurance and had very little to do with "privacy." Thanks to the political machine, the bill was back loaded with requirements and regulations that ensured the privacy of protected health information. Good idea, right? In application, however, large healthcare groups spent millions implementing programs to conform with HIPAA while smaller, private groups struggled to meet the requirements. We are still operating under fear of an audit where a slight deviation from HIPAA requirements will result in outlandish fines. There are a lot of good ideas in HIPAA, but the cost of implementation and continued compliance, I think, was pretty much overlooked.
2) I am of the opinion that private enterprise will always be more cost conscious and efficient than large government. Healthcare is a business and profits drive efficiency. The government does not seem to believe in due diligence or cost comparisons. They rely on contractors to give them honest bids for services, but usually end up taking the lowest bid. Healthcare on the lowest common denominator is a scary proposition.
My argument is "How would you like to go to an ER that is run like a post office?" It may seem extreme, but government employees and contracted employees aren't the most efficient. I think everyone has complained about seeing a road construction crew where one guy is actually working while four others stand around holding shovels. There is no incentive to work. Their jobs are secure whether there are results or not. I don't think doctors would act this way, but support staff may. I think this is where a lot of the inefficiencies of the Canadian system come in to play. It's not that the doctors are sub par or the system itself is broken, but a demotivated government employee working as a receptionist drops the ball and someone falls through the cracks.
Then who do we sue? This may sound counterintuitive coming from a healthcare executive, but our legal system is another check that weeds out incompetence. I am a huge proponent of tort reform because it can get out of hand and malpractice premiums are scaring people away, but the fear of being sued keeps many doctors in check and helps ensure a quality of care.
3) I think another major part of the debate is whether you believe healthcare is a right or a privilege. I think if people are honestly seeking the help, it's there to be found. There is a lot of misuse, however. Too many people use the ER as their sole source for all healthcare needs. You DO NOT need to go to the ER for a runny nose. Some people wait too long to be seen while others go too frequently for every little cough or cold. I also think that our system puts too much emphasis on curing the acute before emphasizing prevention. Is this the system's fault? HMO's have been trying to steer people to PCP's who act as gatekeepers to avoid a lot of this. HMO's usually pay 100% of preventive services, annual physicals, eye exams, etc. The fact is that the people who go straight to the ER don't have a "gatekeeper" anyway. They're treated and told to follow up with their PCP and sent on their way wondering what a PCP is.
The larger issue here is that politicians give the public in general WAY TOO MUCH CREDIT. The utopian idea that persists is that everyone will jump on the bandwagon and learn to use a universal system correctly. I think it will get worse when people realize they don't have to pay for it. Most do, anyway, as the cost for treating a patient in the ER who is unable (or unwilling) to pay is subsidized by overcharging the HMO, another reason premiums continue to rise while payments to physicians and hospitals dwindle.
4) Healthcare doesn't follow the normal rules of economics, so you can't apply the same economic principles as other service industries. In fact, healthcare is backwards from any other industry. The patient has very little choice. The services are recommended rather than sought. I think some of this can be countered through health savings accounts and high deductible insurance plans. This will bring more attention to what a person actually pays for healthcare. Limiting what a doctor can charge doesn't really solve much as fees are usually contracted by your healthcare provider and Medicare sets the standards. Most contracted fees are based in some way or another on the Medicare Fee Schedule. A doctor could charge $10,000 for an office visit, but any insurance is only going to reimburse their contracted rate.
There are many more issues I could discuss. I don't pretend to have all or even any answers, but I think the practicality of a lot of these proposals gets tossed out the window. Most politicians have an extremely myopic viewpoint of issues, especially ones they see as important or use as platforms. The problems arise where the rubber meets the road.
As a manager of medical clinics, I hope that I have a good grasp on many of the issues that have been discussed on this thread. I'll admit I'm not nearly as informed as some, but I think a lot about universal healthcare and have come to the following conclusions, take them for what they're worth:
1) Things on paper look a lot better than they do in application. I like to use HIPAA as an example. It seems to make sense that you would want to protect personal health information and I believe most clinics and hospitals took reasonable steps to do so. I'll bet few people on the board know that the impetus behind HIPAA was the "portability" of healthcare insurance and had very little to do with "privacy." Thanks to the political machine, the bill was back loaded with requirements and regulations that ensured the privacy of protected health information. Good idea, right? In application, however, large healthcare groups spent millions implementing programs to conform with HIPAA while smaller, private groups struggled to meet the requirements. We are still operating under fear of an audit where a slight deviation from HIPAA requirements will result in outlandish fines. There are a lot of good ideas in HIPAA, but the cost of implementation and continued compliance, I think, was pretty much overlooked.
2) I am of the opinion that private enterprise will always be more cost conscious and efficient than large government. Healthcare is a business and profits drive efficiency. The government does not seem to believe in due diligence or cost comparisons. They rely on contractors to give them honest bids for services, but usually end up taking the lowest bid. Healthcare on the lowest common denominator is a scary proposition.
My argument is "How would you like to go to an ER that is run like a post office?" It may seem extreme, but government employees and contracted employees aren't the most efficient. I think everyone has complained about seeing a road construction crew where one guy is actually working while four others stand around holding shovels. There is no incentive to work. Their jobs are secure whether there are results or not. I don't think doctors would act this way, but support staff may. I think this is where a lot of the inefficiencies of the Canadian system come in to play. It's not that the doctors are sub par or the system itself is broken, but a demotivated government employee working as a receptionist drops the ball and someone falls through the cracks.
Then who do we sue? This may sound counterintuitive coming from a healthcare executive, but our legal system is another check that weeds out incompetence. I am a huge proponent of tort reform because it can get out of hand and malpractice premiums are scaring people away, but the fear of being sued keeps many doctors in check and helps ensure a quality of care.
3) I think another major part of the debate is whether you believe healthcare is a right or a privilege. I think if people are honestly seeking the help, it's there to be found. There is a lot of misuse, however. Too many people use the ER as their sole source for all healthcare needs. You DO NOT need to go to the ER for a runny nose. Some people wait too long to be seen while others go too frequently for every little cough or cold. I also think that our system puts too much emphasis on curing the acute before emphasizing prevention. Is this the system's fault? HMO's have been trying to steer people to PCP's who act as gatekeepers to avoid a lot of this. HMO's usually pay 100% of preventive services, annual physicals, eye exams, etc. The fact is that the people who go straight to the ER don't have a "gatekeeper" anyway. They're treated and told to follow up with their PCP and sent on their way wondering what a PCP is.
The larger issue here is that politicians give the public in general WAY TOO MUCH CREDIT. The utopian idea that persists is that everyone will jump on the bandwagon and learn to use a universal system correctly. I think it will get worse when people realize they don't have to pay for it. Most do, anyway, as the cost for treating a patient in the ER who is unable (or unwilling) to pay is subsidized by overcharging the HMO, another reason premiums continue to rise while payments to physicians and hospitals dwindle.
4) Healthcare doesn't follow the normal rules of economics, so you can't apply the same economic principles as other service industries. In fact, healthcare is backwards from any other industry. The patient has very little choice. The services are recommended rather than sought. I think some of this can be countered through health savings accounts and high deductible insurance plans. This will bring more attention to what a person actually pays for healthcare. Limiting what a doctor can charge doesn't really solve much as fees are usually contracted by your healthcare provider and Medicare sets the standards. Most contracted fees are based in some way or another on the Medicare Fee Schedule. A doctor could charge $10,000 for an office visit, but any insurance is only going to reimburse their contracted rate.
There are many more issues I could discuss. I don't pretend to have all or even any answers, but I think the practicality of a lot of these proposals gets tossed out the window. Most politicians have an extremely myopic viewpoint of issues, especially ones they see as important or use as platforms. The problems arise where the rubber meets the road.
Monday, February 4, 2008
Amazing Men
As we watched the funeral for President Hinckley on Saturday, I was awed by the show of gratitude and love for such an amazing man. He truly was a prophet for our time. I had the opportunity to be in the Bountiful Temple baptistry that morning, prior to the funeral services, and was amazed at the spirit that was present as everyone there prepared themselves for the funeral, but we all knew that we were supposed to be there on that day. On Sunday, again we felt the amazing spirit as some of those who attended the funeral bore testimony that Gordon B. Hinckley was and is a prophet of God.
And now, the church moves forward. I was again awed as I watched the news conference announcing the new first presidency. What amazing men are at the head of the church.
I look forward to the leadership and direction of President Monson, another individual who has truly lived the gospel and served in the church the majority of his life. I revere President Eyring as a man of great wisdom and knowledge. I am excited for the call of President Uchtdorf to Second Counselor in the first presidency as well. It truly is amazing to see the hand of the Lord as he prepares and qualifies these men to their positions at their appointed time.
And now, the church moves forward. I was again awed as I watched the news conference announcing the new first presidency. What amazing men are at the head of the church.
I look forward to the leadership and direction of President Monson, another individual who has truly lived the gospel and served in the church the majority of his life. I revere President Eyring as a man of great wisdom and knowledge. I am excited for the call of President Uchtdorf to Second Counselor in the first presidency as well. It truly is amazing to see the hand of the Lord as he prepares and qualifies these men to their positions at their appointed time.
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