Wednesday
Sep192018

It's About You and Your Mother, Mrs. Smith....

     Rarely do I post insights about the personal stories of Advanced Age Seniors, albeit that I am more aware of such stories than are most.  For 35 years, in one capacity or another, I have owned and operated a variety of Senior Care Facilities.  Certainly, I have not "seen it all", but I have seen "a lot". Most insights that I might offer have previously been offered redundantly by specialty bloggers and the general media. Very little in the entire "geriatric landscape" has been overlooked, except that no one wants to go out on a limb and offer critical commentary about the changing  behavior of the "Typical Senior Care Facility Residents" in todays post-Facebook era.  My obervation is that this change has been rapid, dramatic and alarming.

     Yes, there are more men, yes sky-rocketing cost worry residents, yes technology has made many residents more fearful, and yes big-pharma's drug regimes may actually be causing more anxiety, not less,  but.....the new elephant in the room is that:

     Increasingly, Advanced Seniors are melancholy, fearful, and judgmental about their respective families, while their families are increasingly dismissive, inconsiderate and belligerent toward their Seniors.

     My intention is not to speculate on the complex causal dynamics responsible for this visible decline in  intra-family well-being.  I simple want to note that, whether social observers highlight the problem, or not,  it is happening.  Perhaps even more regrettable,  this suffering is often overlooked by care-staffs, who are challenged by bottom-line conscious managers to, if at all possible, "present normal".  Where compelled to intervene care-staff are, these days,  often met with hostility and retribution from both residents and their families. Like it or not, America's "pull no punches" cultural embrace is showing up perilously in our Assisted Living Communities. 

     Further, I saith not, accept to wonder what will happen when everyone feels justified in saying, "Stop calling me, I can't cope any longer"! 

Tuesday
Sep182018

Personalities are Emergent & Cumulative

No baseball player significantly changes his Batting Average in September.  Bret Kavanaugh's 80/20 Traditionalist Worldview is disheartening and ominous, but unless there is a lot of new news, the teenage party story (probably true) is irrelevant.  The good/bad struggle is informed by four dimensional video, not one old Instagram pic.

Sunday
Sep162018

"Versionland"

     Offered by a blogger unnamed, the "Versionland" semiotic is powerful.  Today's cyber enabled world has brought us to a place where the vast number of "event versions" overwhelm any possible collective focus toward truth.  We have only an endless stream of versions.   Naturally, in "Versionland" it is prudent, indeed maybe vital, to reflect and act from a permanent state of doubt.

     Certainly some of the Version-Creep" is simply what happens when everyone has a voice.  Only cursory consideration, however, suggests that much of the 'Version-Creep" is intentional.  Way up in the hierarchy, there is gold-rush to capture the attention of our totally confused and vulnerable "main-street".  We are the pawns in a socio-political migration resulting from the "weaponization of doubt".  Some, like Jordan Peterson advocate that Main-street wrap themselves in a traditional codified belief system to avoid becoming unhinged.  Sam Harris, to the contrary, recommends mindfulness and rational inquire to avoid loosing our bearings.

     At any rate, our attention span is now so shortened via tweets, pods, and sound bites that aggregately we are post discernment/conviction.  We are just gonna hang-out and offer our votes andmoney to the dude with the coolest slogan! 

Tuesday
Sep112018

Slight of Hand.....a Medicare Advantage

     For many years Seniors were somewhat reluctant to give up their "Traditional Medicare Entitlements" in favor of choosing the highly publicized "Medicare Advantage Plan".  Under this option, a private insurance carrier, like Blue Cross, contracts with Medicare to approve and pay for a complement of health services available to a policy holding Senior, in lieu of the services being made available directly from Medicare. Medicare,, in exchange for the Insurance Company assuming this obligation,  pays the Insurance Company a negotiated annual payment for each insured Senior.  The Insurance Companies have made a fortune providing these "Advantage Plan Policies", and, as such, each year they offer new "Advantage Plan" perks to  encourage existing "Advantage Plan" Seniors to switch Companies, as well as to persuade "Traditional Medicare" Seniors to accept their companies "Advantage Plan".

     The competition among Insurance Companies is fierce.  Much like to everyday "cell phone wars" there are gimmics and misrepresentations and outright fraud.  What there isn't is competition with the "Traditional Medicare' option.  Indeed although not publicized, our government wishes every Senior were on an "Advantage Plan".  From a deficit management perspective, it certainly makes sense.  Medicare would rather negotiate with 40 Insurance Companies once a year than try to contain the health spending habits of 50 million Seniors.  Yes, it is a biased metaphor, but it's like the Mafia Godfather, keeping all the foot soldiers in line by putting a few "enforcers" in the middle.  Indeed, the incentives are similar, in that Insurance Companies that don't squeeze their wards, wind up on a higher level hit list.

     This trickle down cost containment strategy is sufficiently oppressive to spawn a million personal tragedy stories and several opposition TV dramas, but it's not the only, in play, maneuver to minimize main street health cost.  Every Insurance Agent making a living selling Advantage Plans knows that the go to explanation for a Senior's anxiousness about trading away Traditional Medicare is that Medicare demands that a Senior can always return from Advantage to Traditional....great, objection overcome.  Except that this truth is often a hollow truth. The expanded real truth is that for most Seniors, Traditional Medicare without a Medicare Supplement Policy, to pick up costs not paid by Traditional Medicare, is an untenable risk.  And, surprised, surprise,  the Insurance Companies cannot prevent Seniors returning to Traditional Medicare, but if they prevent Seniors from obtaining a Supplement Policy they have de-facto locked the Senior until death do they part. 

     The mechanics for blocking Supplement Policies for dismayed Advantage Seniors are everywhere. Exorbitant Supplement Policy Premiums, underwriting prerogatives denying Seniors residing in Communal Housing, as well as rejections for those Seniors having utilized Home Health Services, these are obvious tools.  Fake News claims integrating Medicare and Obama Care, and conspiracy claims of Medicare insolvency are also standard fair.  It many States the Advantage Plan utilization rates are above 80%.  We're getting closer.  What is the old saying about "shooting fish in a barrel"? 

     Oh, Well.  There is nothing we can do about this, we live in a liberal democracy and CNN has convinced me that there is no point in my voting.  My State has been red/blue for a thousand years.

 

Saturday
Sep082018

Gravitas for the Faithful

    A few days ago Sam Harris released the video of his recent Vancouver Public Conversation with Jordan Peterson.  First, it is important to note than ten thousand people paid big bucks to hear a discussion  between two intellectuals..... about God!  This is encouraging in that Peterson, the most recent "darling of the deplorables", is not just another theo-zealot, but is rather a super smart, articulate, fence-walking, atheist neutralizer.  His "books sold" stats prove it.  

    Of course careful and trained attention, to what was literally a debate, clearly favored Harris' "no god" position.  Post Enlightenment, the "no god" argument has become invincible to much of the world,  particularly to <40 educated audiences.  However, there are still countless millions of "not fully committed/not so brave" listeners tentatively holding on to a faith anchor.  Peterson is their savior.  He offers a way out of the much conflicted "I AM/I AINT" dilemma.

    So what's the spin?  My sense is that Peterson; incidental to, or not, having made a million dollars selling books, has successfully recast God in the language of  hyper-consequential cutting edge neuro-psychology. He first, indirectly builds on the Deepak Chopra "quantum uncertainty" extravaganza to justify deities a seat at the table....perhaps, or perhaps not!  For Peterson the "supernatural" really isn't relevant, given that it is not empirically refutable, and as such suffices as this a priori foundation.  From there his argument unfolds as a lesson in the value of "story", speaking to the evidence for "metaphorical truth", as in "better outcomes not withstanding wrong reasoning".  From this claim Peterson meanders into, it seems, every psych-study ever published. Each study reference is choreographed to play a role in his grand narrative. The narrative thesis being that "an evolution ally useful moral foundation can only be imbued from the various God Expressions arising in humanities sacred stories, stories grounded in the a priori uncertainty state. .  According to the logic, there being no otherwise accessible "moral foundation source", it goes without dispute that humanity had best identify with some trans-rational story, be it true or metaphor; least  we are all eventually screwed.  And, oh, by the way, for sure Harris' "reason engine" will not run a human   "moral drive train"... because it is not compressible as is story/heuristics.  Maybe it might run a droid in the future.

    Of course this recounting of Peterson's six hours in Vancouver is from my atrophyed brain and is at best a ramble and at worst trashy confirmation bias, but it does point to an important effort to offer those "stuck" in "God Ambivalence" a way to escape fundamentalism by both "hanging-on and letting-go with a new bit of gravitas".