"Uniformed" Health Care

As the debate over Universal Health Care or Socialized Medicine (or whatever name you’re currently using to refer to the federal government taking over health care) continues, we seem lost for a decent example of how and whether or not it will work. As European versions seem too far removed, we are constantly being told to take a good, hard look at our national neighbors to the North as anecdotal evidence. But, if Shania Twain, Keanu Reeves and Pamela Anderson are any example of our looking to Canada for informative analogs (of cowgirls, surfers or lifeguards, respectively), perhaps we ought to be looking a little closer to home. As it turns out, there is a significant section of the local population, that we can easily examine to inform our decision on the matter, for whom health care (1) has $0 out-of-pocket cost, (2) is run completely by the federal government, and (3) provides questionable levels of care and care availability, and that is, the military.

During my ten years in the United States Navy, people often told me about how “lucky” I was to have “free” healthcare available to me – as if that were the big upside to the woeful underpayment that they referred to as my “salary” and the opportunity to enter a war zone in defense of my country. Nonetheless, this talisman of a benefit seemed to stand out, to them and to most, amongst the myriad of other perks offered to military members. It was as though it was a “Get Out of Jail Free” card for ever getting sick – the ultimate freedom for a population cowed by the incessant fear mongering of the pharmaceutical and medical industries. But I’m here to tell you, not only is it not what it’s cracked up to be, it’s downright horrible. The policies surrounding military medicine along with anecdotal evidence of its failures leads to one conclusion: it’s a bad idea. I can honestly say, the single best thing about not being in the military anymore is having access real health care, and no matter what it costs me, I’m grateful to pay it.

Policy – Oops, OK.

You don’t have to be an economist to appreciate incentives. In fact, one the most important things I’ve learned in business and in law is to be sure and understand everyone’s incentives to the greatest extent possible before negotiating or dealing with them in any way. Incentives can explain even the most ludicrous behaviors. For example, say you’re the heiress to a global hotel empire, and you’ve got a completely unthinkable amount of money at your disposal. Not only do you not have an incentive to work or create any value whatsoever, you also have little incentive to behave in a polite or even lawful manner. You can see what I’m getting at. Of course, these incentives still can’t explain why such a person would be famous, but hey, it’s not a perfect science.

But, with regard to military medicine, the incentive structure is set up to create mediocre practitioners. One of the first documents you sign when you join the military is an agreement not to sue the Government. That’s right, immediately after signing over your life and freedom, you also give up your Constitutional right to legal redress should they fail to live up to their part of the bargain. This also means you can’t sue anyone else in the military. So, you cannot file a suit for medical malpractice, no matter what happens to you. What’s more, the military’s doctors don’t even need to carry malpractice insurance – they can make as many life-altering mistakes as they would like, and the worst thing that can happen to them is a bad evaluation. How free does that medical care sound now?

Seriously, you’re better protected from the kid serving you ice cream at the 31 flavors than you are from your military doctor. Which is great, except that the ice cream guy isn’t cutting you open.

Practice – Don’t Touch the Sides!

Of course, all of this policy jibber-jabber doesn’t really mean much to you in the abstract. Well, lucky for you, I had a few run-ins with my “free” medical care that went a little south of “good practice.”

When I was stationed in North Charleston, South Carolina, I was assigned to shift work aboard a moored training ship to learn how to operate a naval nuclear power plant. One day I had noticed a lump on my inner thigh and wasn’t feeling well. I went to work anyway and began to feel worse. My head was throbbing; I was sweating and had chills. As my visible condition began to worsen I was allowed to go to the clinic on base. After waiting for over an hour just to have my vitals taken, they noted my fever was 103, at which time they instructed me to go to the local Naval Hospital to be admitted. I never saw a doctor there, and they didn’t offer me a ride. So, nearly delirious, and with my temperature rising, I drove myself to the hospital, over ten miles away, where I waited for another hour to have my vitals taken again. This time an actual doctor saw my temperature and admitted me immediately. Safe, right?

Wrong.

After five days they finally determined that my lymph node was infected and would need to be biopsied to determine what was going on. My fever was still up over 102. They ultimately strapped me to a table under local anesthetic to cut into my groin and remove it. Which sounded like an o.k. idea until I actually felt the scalpel cut my leg, to which “doctor” responded: “You felt that?”

In addition this parade of horrors, I also personally experienced the following medical mishaps:

• Waking up in the middle of my septoplasty (surgery to correct my deviated septum – under general anesthetic);
• Four dry sockets after wisdom tooth removal; and
• Having a root canal done on the wrong tooth!

I’d be better off with a medical student whose only surgical experience was playing Operation while drunk at a frat party than letting these quacks cut into me again. At least for him there was some sort of penalty for screwing up – even if it was only having to take a shot of Jagermeister.

There’s no “u” in “free”

Listen, the idea of universal health care is a fantastic one. The altruism is so pervasive that it even feels good just to talk about it. Pairing common access with the world’s finest medical care seems like a no-brainer. But, just like things you buy after midnight from the Home Shopping Network, the reality is a far cry from the promises (OxyClean, anyone?). When the government takes over health care, and more importantly when it takes over compensation to physicians, the incentives to excel, and even the incentives simply not to suck at your job, simply disappear. Much like teenagers, doctors in a consequence-free environment are bound to do some damage – the difference is that the worst thing teenagers will do is raid your liquor cabinet, make too much noise and maybe ruin a shrub or too.

Uniform Health Care will be much the same as “Uniformed” health care – the doctors will have no reason to be exceptional, and you’ll have no recourse if they aren’t. You don’t need to take my word for it, you likely know someone who’s served – and they’ll be happy to tell you. Of course, it’s true, no one will be turned away, but what makes you think that if we forced to world’s automakers to give everyone a car at a fixed, low price that they’d deliver everyone a Mercedes?

Back in the Saddle

This past Saturday I stood back in a familiar place: on a padded cheer floor about an hour from my apartment, in front of a table full of judges, standing beside thirty or so impossibly fit men and women, my wrists secured with athletic tape, and with a fresh sweat dripping down my back from warming up. Nearly 18 months after dismissal by the team, triple-fusion spine surgery and a month removed from my 35th birthday, I was back at Clippers Fan Patrol tryouts.

Just so I don't ruin the suspense for you, I didn't make the team. But, in defense of that failure, I didn't actually try out. After months of agonizing over whether or not I should/would, I made the decision to show up and support the few folks I had trained with, help with warmups, and generally get back in with the crew - but not to submit an application and try out. I had spent the weeks before attending open gyms and reacquainting myself with the basic mechanics of partner stunting. Turned out it was much like riding a bike - except that you have a hundred pounds of girl balanced on your outstretched arm. In that short time, I remastered most of the stunts that I was able do before the surgery, and bulked up sufficiently to look (for the most part) just like I did when I trotted off the court in February 2008. And, even after all that, I decided that I wouldn't be casting my hat into the ring.

Of course, my return to the cheer floor took more than just a few weeks of stunt practice. For the first month after surgery I wasn't allowed to do anything. For the month after that I was only allowed to do twenty minutes on the seated bike. I had lost over 25 pounds and hardly recognized myself in the mirror. I was so embarrassed to be in the gym that I abandoned my evening "rush hour" workouts in a fitted t-shirt for 6 am workouts in a dark ballcap and sweats.

Two months after surgery, despite being cleared by my doctor, the NBA folks thought it was too risky to allow me back on the court for the last game of my last season. After a week of feeling truly crappy about it, I went back to the gym. Soon after, my doctor cleared me for light weight lifting and the elliptical trainer. For the next 3 months, I toiled with 15 pound dumbbells and empty Olympic bars in the wee hours of the morning. After 6 months, I got the green light to train for real. I tenuously ran a mile on a treadmill for the first time. I bench pressed 135 lbs with no more confidence than the first time I had done it nearly 15 years earlier. I still didn't want anyone to see me in the gym.

Two months later, I did a photo shoot for my spine surgeon and the hospital where I got my operation, as a "success story". It was the first time I had even thought about cheerleading since my surgery, and my good friend (and 85 lb flier) Tami agreed to stunt with me for the cameras. The weakness in my right arm was still palpable and visible, but they were able to get some decent shots, and I ended up in an ad the LA Times. Yet, I was still training in relative secrecy. I tried dating again, and it was a mess. I didn't feel like myself and couldn't face myself in the mirror for the first time in almost a decade. I tried alternative therapies - anything I could find, and it slowly began to get better. Injections, ingestions and even accupuncture. Ever so slowly, my arm got stronger, the atrophy in my chest and back began to fade. I started working out without a ballcap. Eventually, I even returned to working out in the evenings - and in a fitted t-shirt no less. I had regained the 25 pounds, and even just a little of my weight room swagger.

Today, my right arm is still not as strong as it was two years ago. I still can't lift quite as much and it's still difficult to see myself in the mirror after a shower. The weakness, even the small amount of it that persists, is still overwhelming.

But I went back to open gym, because I needed the visceral atheticism of it. Of course, I know what you're thinking, visceral athleticism in cheerleading? Listen, once you've taken a girl and throw her from the ground to standing on one arm stretched over your head, you can tell me whether or not you think that's athletic. Until then, shut up. But defense of cheer notwithstanding, I needed to feel that rush, that power again. And I did. The date for tryouts was rapidly approaching and impossibly, I was ready.

But then I thought about what I really missed about being a part of the Clippers Fan Patrol. I first auditioned for the team less than three weeks after moving to Los Angeles. I was completely new in town, with no friends, and no idea what I was getting into (in the city or with the Clips). I had a new grown-up job, where I similarly didn't know anyone or anything. It was crazy to even consider being a professional cheerleader when I had only recently become an attorney. But I made the team nonetheless, and it became my de facto family. It gave me my first real friends in the city: first, David and Steve and later, Joey (who are still my closest friends today), and my first real thing to do besides work. Before I could even catch my breath from moving down from the Bay, I was on the floor at STAPLES Center, throwing around girls in front of screaming fans, the LA elite and more a few celebrities. Our locker room was right across the hall from the team's and running around backstage with NBA players was completely surreal.

For as hard as we worked, we had a blast. We laughed, sweated and yelled. We were a team. We went to the playoffs. We had a time we'll never forget.

But it ended. Because things end. And not always how we want them do. Which was certainly the case with the Fan Patrol. Some of us walked away, others were asked to leave. We made time for other things and came back to games as spectators; which turned into reunions with old friends - ushers, season ticket holders, staff and others. We laughed when asked about when we were coming back to the team. We thought about next year, we thought about never. We talked to the new team members, and listened to how much things had changed and how much they hadn't. And on Saturday I realized, there wasn't going to be any David, any Steve or any Joey on the Fan Patrol next year or any year. And that's when I knew there also wasn't going to be any Glenn.

In the end, no matter how good it used to be, or how much you miss a time, you can't go back again. And trying to do so just seems to cheapen the memory. I made it all the way back to that floor on Saturday to prove to everyone, including and most importantly, myself, that I could. I walked away from it for the same reason.

Levi Blues

This is not the first time I've waxed poetic on inexplicable fame. In fact, one might go so far as to say that it's one of my favorite things to talk about. Inasmuch, I'm likely, on balance, to be more a part of the problem than I am of the solution. But that being as it may, I can hardly stay quiet when the celebrity bar has been lowered so drastically as to make Paris Hilton appear as a paragon of legitimacy. The press has recently added a pundit so amazingly devoid of social value, even the faintest trace of intelligence, or any redeeming characteristics whatsoever, that it's a wonder they put a mic to his mouth the first time, let alone continuing to do it. The inane and predictable commentary offered up by this simpleton is barely qualifiable as English, and consists mostly of the muttering slurry of teen cliches and "you know"s that has to come to represent a generation for whom the term "slacker" seems far too generous. He is the face of never-leaving-the-town-you-grew-up-in, and the kind of young man that keeps the fathers of teenage daughters up at night. He is lazier than Crocs. He is Levi Johnston; the failure of a nation.

It's hard to know where to start with Levi. As a point of review, if you've been fortunate enough to not have heard of or from Levi, let's back up for a minute. Levi came to the forefront of the public consciousness during the 2008 Presidential campaign. His connection could only best be described as ancillary and at worst perhaps parasitic. When GOP nominee John McCain announced Alaska Gov. Sarah Palin to be his running mate, the media was sent scampering. Palin was a relative unknown, and for the briefest of moments, the Republican party seized the momentum of an election which looked more like the coronation of the King of Hope than a real contest. Palin was a former beauty queen with a frontier ruggedness who looked, at first blush, like the kind of woman who could finally break through the glass ceiling of Presidential politics. She was unapologetically conservative and paraded her family around with her as a demonstration of her commitment to family values. But then it all started to unravel. Her teenage daughter, Bristol, then 17, sprung the news that every red-state American parent is dying to hear. Her boyfriend Levi had gotten her pregnant.

The Palins got out in front of the issue by touting the validity of their daughter's relationship to Levi, and fans of the 1960's cheered as the fiction of lasting true love between teenagers got it's biggest shot in the arm since the remake of Romeo and Juliet. Of course, one look at Levi and the shine soon faded on that fantasy. If I were to ask you to close your eyes and imagine the type of young man that at 18 would knock up a 17 year old girl in Wasilla, Alaska (population, 10,000), in between his highest aspirations of becoming a professional hockey player (despite not being recruited to play college hockey anywhere), hunting moose and working as a carpenter, you wouldn't need to see a picture of him. Because he is exactly that guy.

So to review, Levi Johnston is famous for being the useless, wanna-be bad boy cum carpenter who was ignorant enough to have unprotected sex with the Governor's daughter. Oh hey, this just in, his engagement to young Bristol fell apart. Wow. That's the biggest surprise since the sun came up this morning.

Right, well if that's not enough for you, it gets better... or worse, depending on your point of view. Big, hunky Levi has done the classic tattooing your last name across your back or stomach one better. He's got his last name inked on his forearm. That's right, his forearm. Because nothing says "bright future" like eight inches of "Johnston" between your wrist and elbow.

In the interests of producing some sort of intellectual exercise while writing about such an intellectual sinkhole, I tried to come up with a short list of worse things to tattoo on your forearm than your last name in inch-high letters, and could only come up with a few:

• A portrait of a ninja (included mostly because I've actually seen that one)
• The quadratic equation (a good idea when you're 18, but no matter what they tell you, you'll never use it again after you graduate)
• Directions to the "gun show"
• Marilyn Monroe (sorry Megan Fox)
  
• A chili recipe; or
• McCain/Palin '08

It's hard to imagine why we would listen to Levi for anything more than a barometer for social decay as evidenced by American youth, but ostensibly he's being queried for his opinions on the Palin family. Which is a bit like asking Nicole Richie's neighbors to find out what she's up to. I mean, far be it from the Palin family to shy from the spotlight. The entire family is separately negotiating book deals and movie rights - if you want to know about them, just ask. What's more, if they're being especially secretive about something, maybe you should ask someone who isn't cognitively taxed by multi-syllable words. I mean, I know Alaska's not necessarily an intellectual hotbed, but it's also no South Carolina (where you can't throw a rock and without hitting a guy like Levi).

And who is foisting this moron upon the world as some sort of political insider? The usual suspects? TMZ? Perez Hilton? or any of the multitude of checkout lane gossip rags? Oh no. You can get your up to the minute imbecile coverage of the Palin family on CNN and Fox News. And to make matters worse, while countless numbers of aspiring writers (myself included) struggle towards agents and publishers to get their prose into print (and perhaps beyond), Levi is currently negotiating both a book and movie deal. Which is the sort of thing that could put a Lindsay Lohan memoir into Pulitzer consideration (and me into a mountain cabin). I mean, even an intelligent nineteen year old has little if anything to offer in the way of insight, I can't imagine this mouth-breather writing anything that won't make me dumber for having read it.

Listen, guys like Levi play an important role. Every small town high school needs one. Heck, they can usually stand to have a couple. They are cautionary tales for the generations that follow, and want for something better. They are the important lesson that a girl learns about bad boys, idiots, or anyone who lives their lives vicariously through their MySpace page. They are the karmic revenge on the popular girl who wasn't very nice to anyone, as they are five years away from a trailer, a baby running around outside in only a diaper, and domestic violence rap sheet. They are the context for your reunions that make you feel like you've accomplished something. What they are not, is anyone that should be in the news cycle any longer than it takes to recount the details of their tragic demise.

We can do better, and in fact, we must. In a nation where a healthy sense of shame seems harder and harder to come by, we still need to be ashamed of young men like Levi. Because it's only when we turn the public eye off and the evil eye on that we have a hope of discouraging them. And with a little luck, maybe the only thing your daughter's boyfriend will need to remind him of his last name is his driver's license.

Afflicted

Through most of my adult life I have had the good sense and/or the good fortune to not have gotten caught up in the majority of ridiculous fashion trends that have afflicted most of my peers. There was my ten years in the Navy, which obviated the need to have much fashion sense; since the majority of time I was in uniform, and when I wasn't, my haircut gave away any hopes I had of blending in. Then there was law school at Stanford, where all I needed to fit in was a few hundred dollars worth of Abercrombie & Fitch (which hadn't become as douche-tastic as it is today). Finally, there was living in Los Angeles, and a decent amount of disposable income to spend on clothing - and by that time, I was over thirty and had just enough life experience to have developed my own understated sense of style. And so it is that for most of the fashion faux-pas that I rail against, I have never participated in them - which either validates my point or ruins my credibility depending on your point of view. But, there are a few fashion tragedies that I have been a part of in the past, that I've subsequently determined to be ridiculous. As tradition dictates, whenever I spot someone who hasn't yet seen the light and cast such nonsense aside, I mock them mercilessly. Hypocrisy, you say? You betcha. But, better to be right late, than never. And, it still doesn't stop it from being funny.

I hate for one brand to bear the brunt of my criticism for an entire genre of clothing, but since they had no problem being the flagship for faux bad-assery (FBA for short) when it was making them millions, I have no problem throwing Affliction under the bus for being the easiest way to spot a douchebag short of having them actually wear scarlet D's. I can recall the appeal of more artistically designed and printed t-shirts when Abercrombie was unwilling to produce anything that didn't have either a large number or cheeky sexual innuendo printed on it. I even bought some of these shirts; willingly laying down $60-$80 per shirt with the hopes that my t-shirt sophistication would make it obvious that there wasn't a futon anywhere in my furniture collection. Unfortunately, the responsible design group soon jumped the shark, and everything they produced had either a cross or a skull on it, along with an obnoxiously-sized and wannabe gothic version of the brand name. This is where I got off this particular fashion train, and none too soon.

Honestly, since when does wearing a cross make one a tough guy? The only kids I can remember who had to have skulls on everything were the same ones who thought that denim jackets never went out of style and that Metallica was an actual religion. And what's with the super-sized logo? I haven't seen branding that ridiculous on clothes since, Z Cavaricci (yeah, let that one take you back for a minute). Seriously, if I can tell what brand t-shirt you're wearing from fifty yards away, what are the chances you're not an ass? As if the giant cross and skull weren't bad enough. Every time I see one of these shirts now, my imagintion produces a deep baritone voiceover that yells "Affliction!" like a thunderclap. Which is precisely what I believe the wearer of such shirts to be the desired effect. Of course, I suppose that I'm then supposed to be so overwhelmed by the sheer badness of their clothing that I will be sure to stay out of their way not make any direct eye contact. In reality, I'm just trying not to laugh out loud, and leaning over to whisper to my companion, "Affliction bingo, plus one!"

That's right, Affliction bingo. A fun game for all you reasonably sane folks out there the next time you're at a concert, sporting event, movie, mall or other place you can expect find young men under the age of thirty. One point for every piece of Affliction clothing you can spot first, and double points for more than one piece on the same person. Of course the entertainment that you get from this game probably falls under the laughing-to-keep-from-crying category - but it's better than waxing poetic on social decay or worrying about how seriously underqualified the next generation of adults will be to do anything that doesn't involve their MySpace page. If you're looking to get a high score, I'd recommend a mixed martial arts event. Of course, here you'll find even more egregious examples of FBA, in the brands that have grown up around this new sports phenomenon.

Don't get me wrong, I'm a fan of MMA. There will always be a demand for combat sports, and our bloodlust, if anything, has gotten stronger as we've become (arguably) more gentrified. Boxing was swirling the drain like the discarded hair from your man-scaping and we needed something that more real than pro wrestling and did not involve Don King. MMA answered the call. Unfortunately, the minimal gear and the nature of the combat has made the sport so accessible that every knucklehead who's ever been in a bar scrap now thinks he's two Ju-Jitsu lessons away from being a professional fighter, and wants to make sure everyone knows it. And, the aforementioned apparel companies have been happy to oblige. Now the streets are full of crew-cutted posers who expect that wearing a TapOut shirt is license to act as though they're a Mike Tyson in waiting who ought to be cut as wide a swath as possible. I swear that these guys are walking around with the Rocky training montage music playing in their heads. Of course, they're usually performing this menacing gait through a shopping mall parking lot on their way to their silver Honda Civic; the one with the do-it-yourself window tinting and exhaust modified to make it sound like a very angry lawnmower. Please.

I'm certainly not placing these brands at fault. For every quick fix we've ever desired, there's always been someone willing to peddle it to us, at a premium. And the need for wash and wear masculinity has obviously never been higher. The world has certainly feminized in the past few decades, and the opportunities to register one's value as a man are fewer and farther between than they've ever been. But, what sort of man needs to wear his toughness on his t-shirt? And, in a room full of men all wearing the same intended "bad-ass" label, how can you tell who the real bad ass is? Well, the terror imposed by skulls and crosses notwithstanding, he's likely the one whose shirt says nothing at all.