Monday, May 2, 2016

Picturing dementia: empathy, insights, and the occasional belly laugh

[One of Chast's unforgettable cartoons]
Some 25 years ago my parents and one of their best friends, Gertrude, started showing signs of dementia. As their conditions worsened, Gertrude’s daughter Ann and I began trading morbid geriatric jokes. Laughing helped us face the daily struggles of caregiving: it felt so much better than crying.

 In 2014, New Yorker cartoonist Roz Chast published a graphic memoir about her aging parents that would have been perfect for Ann and me. Can’t We Talk about Something More Pleasant?... is often improbably funny. Its comic-strip presentation is poignantly true to life: frazzled caregivers will recognize themselves on every page, and they may also see aspects of their parents in Chast’s clueless father and ferocious mother. Chast’s drawings let us cry, and then they make us laugh—sometimes simultaneously.

These are the opening paragraphs of "Picturing Dementia," my double review - of Chast's book, and also of Dana Walrath's Aliceheimer's - in the May 11, 2016, issue of Christian Century

You can read the whole review online (and see more brilliant drawings by Chast and Walrath) at

I hope you will. If someone you love has dementia, you probably need these books.

Wednesday, April 20, 2016

Why this is the perfect time to vote for Bernie, even if you don't want him to be president

I voted for Bernie today. I am not sure he'd make a good president.

What I like about him--his refusal to be bought, his idealism, his modest lifestyle, his populist appeal, his independence, his concern for the common good--are the very characteristics that would probably make it hard for him to govern a nation that's in thrall to Money and Power.

But I voted for him anyway, even though it's highly unlikely he'll be the candidate in November.

And if you're a Hillary supporter in one of the 18 states still awaiting their primary, this is the very best time to vote for Bernie. Your vote will not make Bernie the candidate, but it could very well make Hillary a better president.

I voted for Bernie because Hillary needs to hear his message, over and over again. She needs to hear it so insistently that it will get through to her in spite of the power brokers who have financed her campaign.

She needs to know that a lot of us think she is dangerously hawkish. Her vote in favor of the Iraq war might be excused based on the misinformation available at the time, but her handling of Libya (and I don't mean Benghazi) shows her eagerness to rush in where better angels fear to tread.

She needs to face a continuing, relentless wave of public protest against her ties to big money sources including Wall Street and foreign governments.

If she becomes president, she needs to use her admirable skills to get Citizens United reversed and to do whatever it takes to assure that elections are never again bought and sold.

If she doesn't pay attention to those of us who wistfully admire Bernie's principles, the United States may soon be in big trouble. The rest of the world has gotten fed up with rich bullies. Despite their blustering, the sun did set on the British Empire, and it could soon set on ours.

I wish we had a candidate with Bernie's ideals and Hillary's political savvy.

But since we don't, I voted for Bernie because his heart's in the right place. And in November, I expect I'll vote for Hillary because her heart was once in the right place too... and maybe we Bernie supporters can help her see the light once again.

Tuesday, April 12, 2016

DOLLAR car rental update

That certainly has been our experience. Repeatedly.

See my earlier post, "Beware DOLLAR's "Lock Low and Go" Scam!" for the whole story.

When the Better Business Bureau intervened, Dollar offered us partial reimbursement of the money they overcharged us. We refused their offer. If a price is guaranteed, that's the price we should pay. Unlike the Dollar manager we dealt with, we believe that's what "guaranteed" means.

UPDATE: Dollar has now agreed to refund the full amount that they overcharged us. We have told the Better Business Bureau that we accept this resolution, but that it shouldn't take repeated calls to customer service followed by complaints to the BBB, to the Chicago Department of Business Affairs and Consumer Protection, and to our credit card company to get a company to honor its guarantee.

I have not enjoyed pursuing this scam. I often thought I'd rather just let it go--it wasn't all that much money. But then I thought of all the thousands of people who rent cars at Midway Airport. If all of us who are overcharged take action against scammers, maybe the car rental companies will figure out that there's more profit in being honest than in trying to repair the damages caused by dishonest employees.

Wednesday, March 23, 2016

Beware DOLLAR's "Lock Low and Go" scam!

Looking for a good price on a car rental? Dollar and its partner, Thrifty, have some of the best prices online. But sadly, when you use their "Lock Low and Go" promotion, you risk being scammed.* We found this out the hard way last weekend when we tried to pick up our reserved car at Chicago's Midway Airport.

Here's how the scam works:

1. On their home page, Dollar guarantees you a Compact car or larger vehicle for the price of a Compact car.

2. Click "Learn more," and you see that Dollar defines Compact car as a vehicle that has room for, and seat belts for, at least five passengers.
This sounds good. You see that you can save even more money by paying in advance. So of course that's what you do.

3. You go to the Dollar counter at the airport, and the agent offers you a Chevy Spark.
Now, I love Chevy Sparks. I own one, in fact. But a Chevy Spark has four seat belts, not five, and is by no means a compact car. At 144.7" long, it is 15.3" shorter than a Honda Fit, 12.6" shorter than a Prius C, 10.8" shorter than a Toyota Yaris, and even 6.4" shorter than a Mini Cooper 2-door hatchback.

4. Realizing that your three passengers and their bags can't possibly fit in a Chevy Spark, you protest that such a small car must certainly be an Economy car, not a Compact car.
"Yes, I know it's small," the agent says, "but Dollar classifies things differently, and we call it a Compact." You dispute this with her for five minutes, but she will not budge. No other Compact cars are available, she says.

5. The agent tells you that you have only two choices: take the Chevy Spark, or pay more for a larger car.
She offers you a Midsize car for $10 a day, plus airport taxes and fees, which increases your total by $52.54. You argue some more. Nothing can be done. You are traveling to an important appointment. You do not have time to continue the discussion. You have already paid for a Compact car, so you can't just step over to a competitor's counter.

6. You take the larger car and agree to the added $52.54. What else can you do?

7. Later, you go back to Dollar's website. You reaffirm that Dollar's Lock Low and Go promotion guarantees a Compact, 5-passenger car or larger. You also confirm that Dollar considers the Chevy Spark an Economy car, not a Compact car.

You note the descriptions of Economy cars (4 passengers), Compact cars (5 passengers), and Lock Low and Go cars (5 passengers).

8. You call Dollar's customer service department, repeatedly.
They are closed for the weekend. So you call back early Monday morning. In fact, you call three times and talk to two agents.

9. The agents tell you that you must try to resolve this with the manager where you rented the car. 
You point out that it is most likely the manager who caused the problem in the first place. You remind them that you will be there to catch a plane and won't have much time. No matter. That's the only way you can do it.

10. You go to the airport three hours before flight time in order to talk to the manager. The manager refuses to refund the money you should not have been charged in the first place.
You show the manager that Dollar's website guarantees a Compact car or larger. You show him that Dollar's website classifies the Chevy Spark as an Economy car. He acknowledges both facts, but he says that, as manager, he has the right to offer you any car he wants. He says that you agreed to take the Midsize car instead of the Economy car (even though the Economy car was inferior to what you had reserved and was unusable), and that therefore it was correct to charge you extra.

11. Without your consent, the manager credits your bill with $20 (because he's a nice guy, he says) and tells you he has closed your account. 
Frustrated, you phone Dollar's customer service department right there. After a long wait, an agent comes on line and asks you for a lot of numbers. You give them, and the agent then asks for them again. Eventually the agent transfers you back to the phone tree that you got when you first called. You wait a long time again. The second agent also asks for your numbers twice. She speaks softly, and you can't understand her. You ask her to speak up, and she says she can't or she'd disturb other agents. You stay on the line and listen as hard as you can.

12. After several calls and long waits, a customer service agent tells you that your account has not been closed, so she can't help you. 
You have a plane to catch. You take the bus to the terminal.

13. You turn to Twitter.
You: Hours spent trying to resolve @DollarCars scam at MDW. Avoid Dollar everywhere? Or just at MDW?
Dollar: @[You] Hi [You], very sorry to hear of this. Please DM us your reservation number and rental record number so we can take a look. - TC
You: @DollarCars my res no: [...] & my RR: [...].
Dollar: @[You] Were you able to rent a vehicle today? Please dm us for further assistance. 
14.  You have already spent many hours trying to get Dollar to honor their guarantee, to no avail. You decide that $34.54 (the extra charge minus the credit) is a small price to pay for what you have learned: You will no longer rent from Dollar or Thrifty. If they are blatantly dishonest and unhelpful about this, can you trust them with anything else? And you will warn your friends about them too.
* I do not know if Dollar is a dishonest company that intentionally scams its customers. All I know is that this is what happened to us at Chicago Midway's Dollar counter, that several employees at Midway told us confidentially that we are not the first to be so scammed by Midway's Dollar, that it would be a very easy scam for any rental car agency to pull off, and that Dollar's customer service department has been completely useless in resolving it. If they do eventually resolve this to our satisfaction, I will certainly post an update. Meanwhile, let the buyer beware.

Tuesday, February 16, 2016

The 2016 Candidates and the Missing Middle

In this oddest of presidential election seasons, one odd fact is rarely mentioned: the curious age spread of the candidates.

At their first inauguration, our 43 U.S. presidents* have ranged in age from almost 43 to almost 70. More than half were in their 50s. Their median age was 55, and so was their average age.

But in 2016, now that we're down to eight candidates (Bush, Carson, Cruz, Kasich, Rubio, and Trump vs. Clinton and Sanders), not a single candidate is in his or her 50s.

Rubio: 45 years, 237 days
Cruz: 46 years, 29 days
Bush: 63 years, 343 days
Kasich: 64 years, 245 days
Carson: 65 years, 124 days
Clinton: 69 years, 86 days
Trump: 70 years, 220 days
Sanders: 75 years, 134 days

A few 50-something wannabes have dropped out of the race (Christie, O'Malley, Paul, Santorum), as did some 60-somethings (Huckabee, Fiorina, Gilmore). If the polls are right, the remaining 60-somethings who have not yet reached Social Security's full retirement age (Bush, Kasich, Carson) will not be in the running much longer. If they drop out, we will be left with no candidate over 46 or under 69 on January 20, 2017. 

I made a chart to see how weird this is. The current candidates' ages are highlighted in yellow.**

To see a chart you can actually read, click here.
Cruz and Rubio are younger than every elected president except John F. Kennedy (Teddy Roosevelt was even younger, but he became president when McKinley was assassinated).

Clinton is older than every president except Ronald Reagan. Trump and Sanders are older than any president ever.

Looked at another way, the most likely candidates are either younger than my firstborn or older than me. I find this slightly scary.

*Yes, I know Mr. Obama is #44 - that's because Grover Cleveland, who was elected to two non-subsequent terms, is counted twice in most lists but not here.

**Red print indicates names and ages of the 16 presidents who served at least two nearly full terms. Except for Ronald Reagan, none of these was older than 62 at first inauguration.

Saturday, December 12, 2015

Why single-payer healthcare funding may not work in America

Of course Obamacare is failing.

Not quite as badly as No-Obamacare was failing, so I'm still glad it exists. It's a necessary stopgap until we find a system that actually works.

But you know what? Single-payer healthcare will fail just as badly.

In 2015, U.S. spending is projected to hit $10,000.
Yes, I know that single-payer healthcare systems succeed in other developed nations. I also know that competitive insurance-based healthcare systems succeed elsewhere. But neither system will succeed in the United States, because the U.S. is the only nation on earth that refuses to keep healthcare spending from spiraling out of control. If the cost remains the same, it doesn't matter who's paying. In the long run, we all are.

Many Americans believe that a free market would drive spending down, but the American healthcare mishmash (both before and after Obamacare) is definitely not a free market. Just try finding out what a procedure is going to cost so you can choose the least expensive provider. Even the providers have no idea until they've already signed you up and run your insurance numbers. If you're computer literate and have lots of time and patience, it's possible to get approximate prices for prescription drugs, but what can consumers do about profiteers like the infamous Martin Shrekli?

And anyway, when you're being rushed to Emergency is no time to comparative shop.

Many in the general public scream "Rationing!" whenever any limitation to healthcare is suggested, no matter how sensible it may be (refusing to fund drugs with no proven benefits, for example, or allowing futile, often painful, but expensive procedures for people in the last stages of dying). It's frustrating when we grow up and realize that we can't all have everything we want, but it's rational to make sure that, when something (like money for healthcare) is in short supply, it's apportioned wisely for the common good. Americans are not rational about rationing.

Congress, as the right arm of lobbyists, has no interest in keeping healthcare affordable. They would not pass either George W. Bush's Medicare prescription drug plan or Barack Obama's Affordable Care Act until all threat of price caps was removed. Medicare is not even allowed to negotiate drug prices.

Well, folks,
  • if consumers are unable to do comparative shopping;
  • if we all believe we have a divine right to any healthcare that's available, no matter how expensive or ineffective it may be;
  • if we will not allow our healthcare payers to set price ceilings or negotiate lower prices;
  • and if our lawmakers continue to favor the lobbies who fund them rather than the people who elect them;
of course our healthcare system will fail.

It will fail millions of people who cannot afford the treatment they need. It will fail millions who pay high prices for treatment they don't need. It is failing all of us, since we pay twice as much for healthcare as we would pay in other developed countries.

Until we find an effective way to limit healthcare spending, American healthcare will continue to fail--whether it is funded by private individuals, by competing insurance companies, or by a single payer.

Wednesday, September 23, 2015

A nonpartisan plea to American candidates, pundits, political marketers, and my Facebook friends

Please don't tell me what will work in 2016 and beyond unless you also show me what has worked in previous years, or what is working right now in other countries.

Take healthcare, for example. Don't tell me what will work in some theoretical universe. Show me what is already working in the universe we live in. It's not hard to find information about other countries' approaches, costs, successes, failures, and overall health results. If you want to change our current system of healthcare--and I think we all agree that changes are necessary--how about basing your recommendations on some system that is already more successful than our own? 

Or consider taxes. Forget ideology. Look at our own history. When the highest earners paid a lot more in taxes, did business prosper or lag? When the trickle-down theory became popular, did inequality increase or decrease? When taxes were lowered, did we find it easier or harder to pay for things we value like roads, bridges, and veterans' benefits? When was the average American most prosperous? What was the tax structure then?

Most of us want Social Security to thrive, though we have different proposals for how this should be achieved. To those who think the system should be privatized: how about showing us what happened to pensions when they were largely privatized a couple of decades ago? Who benefited? Who lost out? To those who think earned income over $118,500 should be taxed, how do other developed countries take care of their retirees? Are any of their systems more effective than ours?

Or how about the minimum wage? We all want people to be able to find work that will support themselves and their families. Did American businesses thrive or languish when our minimum wage was proportionately much higher than it is now? Was poverty more or less widespread? Many other developed countries have a minimum wage that is higher than ours. Has this helped or hurt their economies? Has it helped or hurt job-seekers?

Or gun control. Are we safer when citizens are armed, or when they are not? What has happened in countries that have restricted gun ownership? How do our homicide and suicide rates compare to those of countries who regulate firearms more strictly than we do? What proportion of our homicides and suicides are gun related? Do countries that restrict firearms have a large number of criminals who use them anyway? If not, how do they prevent this?

Or abortion, a contentious subject if ever there was one. Instead of positing a paradise (for either conservatives or liberals) where no unwanted child is ever conceived, how about looking at what actually reduces the abortion rate? Which countries have a lower abortion rate than ours? Which ones achieve this without increasing maternal death from unsafe abortions? What policies and practices enable women in the more successful countries to avoid unwanted pregnancies and to raise the children they have conceived?

Or foreign policy, or civil rights, or regulation of financial institutions, or immigration, or education, or the environment, or poverty, or ...

None of these issues are new to Americans. We have dealt with all of them before--sometimes with good results, sometimes not. Why aren't we paying more attention to what has worked, and what has not worked, in the past?

And none of these issues are unique to Americans. Other countries also deal with healthcare, taxes, pensions, wages, firearms, abortion, and a host of other concerns. We can see where they are succeeding and where they are failing. Why aren't we paying more attention to what works, and what does not work, elsewhere?

I'm tired of exhausted ideologies. I'm tired of tear-jerking anecdotes about individuals who illustrate your point of view, or mine (it is easy to find heartwarming or infuriating stories that bolster opposite viewpoints on every one of the issues listed here, but they prove nothing). I want real-life, broad-scale examples from history or from other countries, well supported by reliable data.

The information is readily available. If you want my vote, or my respect for your opinion, inform yourself--and then show me what works. In the real world.