Several weeks ago a social media friend of mine (female) asked what I regarded as a  monumentally naive question – why are men so enraptured with sports? The discussion that followed, including some comments from men, was also a bit on the simple side:

“It’s their competitive nature. ‘Mine is (bigger/ harder/faster/etc.) than yours!’ “

“Marketing run social conditioning.”

“Most men deeply wish they could have been professional athletes and earning money playing children’s games.”

To be fair, there is truth in all three of those statements. However, the relationship between humans and athletics runs far deeper than that. The real point, as I see it, is to discuss how sports have become so deeply ingrained in our culture, and not just American culture.

Let’s start with a basic truth – physical fitness is good for us. We’re reminded with regularity that exercise throughout life will increase our longevity. Our bodies were made for moving, and so we move.


A depiction of Fisherman Jousting

Human competition has very ancient roots. Cave paintings have been found in the Lascaux caves in France that seem to depict sprinting and wrestling about 15,300 years ago. Scientists believe the Mayans played a form of soccer with severed human heads. Ancient Egypt featured a sport known as Fisherman Jousting that commonly resulted in the deaths of the losers, and if the game didn’t kill you the hippos and crocodiles lurking in the Nile had a shot. Ancient Native Americans played something called Chunkey, and it was taken so seriously that losers were known to commit suicide.

Relatively speaking, maybe we aren’t so enraptured with sports, after all. And yet they dominate our culture, from childhood to the grave. Boys and girls play soccer, baseball and basketball; they compete in tennis, swimming, gymnastics and cheerleading. Some boys still play football. By the time they reach high school, if not sooner, the games become more pressurized, with much less actual play time. A weeding out is already underway as players are sized-up for the next links in the chain – varsity, college, maybe even pro sports. Kids are cogs in a wheel that keeps billions of dollars flowing in big-time NCAA Div. 1 football and basketball, the NBA, MLB, the NFL, and a number of international soccer leagues.  On the women’s side, while the opportunities and money are much, much less, colleges and universities of all sizes offer athletic scholarships that are highly prized by families struggling to make ends meet.


Soccer superstar Cristiano Ronaldo.

It’s easy to dream big. The highest paid athlete in the world, Portuguese soccer star Cristiano Ronaldo, earns a staggering sum of money, approaching $100 million a year between his salary and endorsements. American basketball player LeBron James isn’t far behind. The richest pros basically have hit the lottery and with sound financial planning are able to provide for multiple generations of their families. The “lesser paid” players don’t do so badly, either. The average salary in MLB is $4.47 million; in the NBA it’s $6.2 million: in the NFL it’s somewhat lower, $2.1 million, in a league where the average career is short – about three years. In any case, it’s life-changing money and–yes–millions of American males wish they could be there.

For boys in particular, organized sports can be the first place where they truly experience success. If they struggle in school, as my son did, this is crucial. Their self-image can receive a much-needed boost. As a father, I’d rather see success in the classroom, as that probably opens more doors over time, but I think any parent would agree that you build competencies where you can. In addition, being part of a team is an essential lesson for any child, as is winning and losing. We experience plenty of both in life.

As we age our relationship to sport generally changes. Very few of us continue to compete in team sports other than beer league softball, and the struggle for fitness tends to be increasingly uphill. But we remember what we were, and we appreciate it more than we did when we were in the middle of it. So we look back, remembering the games we played, striving to understand them more, gently steering our children to them, and developing a keener appreciation for those who play at the very highest level. A world-class athlete is worthy of our admiration, and human competition at any level is worthy of our support. In short, our love of sport is nothing less than a love of life itself.

I hope I have answered the question.




Reno and me


I first visited Reno, Nevada in 1974, when I was 15 years old. It was the preferred vacation destination of my grandparents, who lived in eastern Oregon and regularly motored down old US-395 to play the slot machines. So our family drove north from the LA-area to meet them and take in the “splendor” of the so-called Biggest Little City in the World.

My dad prepared us by proclaiming Reno “the armpit of America,” although he may have said asshole. I can’t remember for sure. It was definitely nothing to get excited about, especially for three kids still years away from legal gambling, drinking and smoking, which appeared to be the extent of local activities at the time along with illegal prostitution. While the world’s oldest profession is permitted in most of rural Nevada, it’s not in the state’s urban centers and hasn’t been for decades.

Shifting ahead to 2018, I have probably been to Reno 50 times. It’s just a two-hour drive from my home of the last 30 years – Sacramento. I’ve been on day trips and overnight excursions; traveled there for work and pleasure; attended concerts (the city draws some excellent acts) and knocked around antique stores and junk shops. Gambling, drinking and smoking (and illicit nookie) are still major reasons to go, but that is gradually changing.

Metropolitan Reno has a population of about 450,000 and entertains between four and five million tourists annually. It is no longer little. It’s a university town (the U of Nevada is the region’s second largest employer), a ski town (the nearest resort is 11 miles from the airport), a farm town (cattle ranching and alfalfa hay), a museum town (including the world-renowned Harrah’s auto collection), a casino town (of course), and a reasonably priced lodging and residential alternative to the nearby Lake Tahoe Basin.



In the remaining years our family vacationed together we returned to Reno several times, always staying in the same place as my grandparents, the Capri Motel. It’s still there today near the high-rise casinos, offering quite inexpensive rates, which is no doubt why my famously thrifty grandpeeps preferred it. They stayed there so often they became friendly with the proprietors and regularly exchanged Christmas cards.

One of my most enduring memories is walking very slowly with my elderly grandfather from his favorite casino, the Nevada Club, back to the Capri. Whether we were with him or not he would walk the half-mile late at night with an enormous wad of bills stuffed in a pants pocket. To our knowledge he was never disturbed; at least he told us he wasn’t. And that was kind of surprising given the starkly destitute nature of the place. Seventies Reno was run down. A grimy film clung to it, like you might expect of a place regarded as the armpit or asshole of America. It was a town in need of a hot bath and a shave, and some serious public investment to clean it up.


More memories

Much of it was getting worse in 1997 when a group of my closest friends decided to hold my bachelor party there. It was the type of weekend you might expect; not as bacchanalian as some, a little more raucous than others. To be fair, though, Reno had made some changes by then, connecting some of its most prosperous casinos–the Silver Legacy, the El Dorado and the Circus Circus–in an indoor mall format allowing you to sample the restaurants and casinos of all three without having to walk outside. For the most part you didn’t want to go outdoors, although I did early one Sunday morning, walking alone to the Nevada Club to share some space one more time with the memory of my grandparents. When the casino closed for good six months later I was very glad I did.

What I like to call the downtown casino triplex is still a major draw in Reno, but there are signs of life elsewhere. For years there have been two casinos to the south–the Peppermill and the Atlantis–that seem to draw enough business to stay afloat. I’ve never been to either but I’m told they’re nice. An enormous property just north of the airport–originally the MGM Grand but now the Grand Sierra Resort–seems to be flourishing. And Harrah’s has been a solid citizen for decades.

River Walk

The River Walk

But one of the most exciting developments is along the Truckee River on the south end of downtown. It’s called the River Walk district and it’s really coming into its own as a dining and entertainment center apart from the casino culture. On a recent visit we had two fine meals there at restaurants dedicated to local procurement and stayed for a night at the Renaissance Hotel, a recently-refurbished Marriott property right on the river that doesn’t have a casino and is family-friendly and smoke-free. However, when we opened our window to listen to the rushing river as we slept we were treated to shouting and singing from the homeless and the drunken as they meandered along the River Walk in this 24-hour town. And this was in March, when there were snow flurries. Imagine what it’s like during the summer. Still, it’s progress.

Someone I worked with in the media years ago now does radio news in Reno and recently said she never wants to leave. She calls it a progressive town, hip even, and she’s a fan of the steady parade of festivals conjured up by civic leaders to pack in tourists. They include a rib cook-off, a river festival, a jazz festival, Italian and Celtic festivals, a blues festival, a motorcycle rally, and the granddaddy of Reno festivals, Hot August Nights, which is a giant classic car show.

It seems I’ll be spending quite a bit more time in Reno in the near future. My elderly mother is in a care home there along with her husband. They moved down from the Puget Sound region to be close to his daughter. The good news is I like the place – I really do, and I have for years; warts and all.


The search for an elusive soul


Photo from the New York Times.

The three years since Donald Trump first announced his campaign for president have been a dizzying, stressful blur. Our country has been through a full range of emotions, and the man continues to stir visceral reactions in many Americans.

Part of Trump’s attendant circus is a crew of journalists searching for the “real” man. They’re still wondering – is there more to him than his carefully cultivated stage image? Is there hidden depth, a reserve of gravitas, that will surge to the fore in times of crisis? In the beginning many people, including those who opposed his candidacy, wanted to believe that. Hell, they desperately needed to believe it.  Unfortunately, the evidence accumulated so far suggests otherwise. It seems the occupant of the Oval Office is authentically what many have considered him to be for decades – an astonishingly shallow, thoroughly unethical salesman.

As for Trump’s ability to grow in office, or act “presidential,” he may possess it deep down somewhere in his psyche, but he is clearly not interested in exploring it and–alarmingly but predictably–he has taken a cynical approach to criticism about it.

A story recently in the New York Times Magazine chronicled a Trump campaign rally for Pennsylvania congressional candidate Rick Saccone where he, Trump, reacted to the criticism this way:

“I’m very presidential!” Trump told us, with mock indignation. Then he stiffened in his suit and adopted a stentorian tone, like a fourth grader doing an impression of his school principal. “Laaaadies and gentlemen,” he intoned, “thank you for being here tonight. Rick Saccone will be a great, great congressman. He will help me very much. He’s a fine man, and Yong is a wonderful wife. I just want to tell you on behalf of the United States of America that we appreciate your service. And to all of the military out there, we respect you very much. Thank you. Thank you.” He broke character for a second: “And then you go, ‘God bless you, and God bless the United States of America, thank you very much.’ ” He turned and faced the V.I.P. guests in the riser behind him, and did a sort of rigid penguin walk. The crowd whooped and laughed…It took a few more seconds for the spectacular strangeness of the moment to settle in: We were watching a sitting American president imitating an American president.

It genuinely seems that Trump has respect for nothing unless it makes him money.

The writer of the story went on to observe that in watching Trump on the campaign trail, he believed he was seeing the essence of the man, much like you might when watching Barack Obama reflecting quietly in his study, or like an exchange with any normal person in a private, unguarded moment. In this analysis the public Trump is the private Trump. Beneath the surface it would appear he is like Gertrude Stein’s description of Oakland – there is no there there. That may be why, following a fire last weekend at Trump Tower that killed a man, Trump boasted about the durability of his building while offering not a scintilla of sympathy for the deceased or his family.

That character quirk doesn’t keep Trump from lashing out viciously on Twitter. In fact, it may actually fuel the behavior. His latest target is, of course, former FBI director James Comey, who has likened Trump to a mob boss in interviews promoting a book to be released next week. Comey stated that Trump is “untethered to truth” and said Trump demonstrated a fixation with stories about Russia and the so-called ‘pee tape’ in their private meetings, saying to Comey at one point, “Can you imagine me, hookers?” and then, “If there’s even a 1 percent chance my wife thinks that’s true, that’s terrible.”

James Comey is a truly legendary government lawyer – a Republican like Trump, but one who worked across the aisle, serving Presidents Clinton and Obama as well as George W. Bush. He has actually prosecuted Mafia figures, so the mob comment had a strong foundation behind it. In Beltway and legal circles Comey’s integrity has been regarded as beyond reproach, even though he drew extensive heat from both major parties for his handling of the investigation of Hillary Clinton’s email server in the run-up to the 2016 election. By contrast, Donald Trump and his businesses have been involved in more than 3,500 lawsuits, a great many of them triggered by an alleged lack of integrity. An example is the fraud-riddled “Trump University,” a scam that resulted in a judge recently approving a $25 million payout to victims. Yet on Twitter, Trump called Comey an “untruthful slime ball.”

So as journalists and others continue their search for the real Trump, the elusive soul of the man, we wish them well, and we have our doubts. Among the many observations of James Comey are these:

“His face appeared slightly orange, with bright white half-moons under his eyes where I assumed he placed small tanning goggles.” 

“I stared at the soft white pouches under his expressionless blue eyes.”

Speculating as to why he never saw Trump laugh, Comey said: “Deep insecurity, his inability to be vulnerable or to risk himself by appreciating the humor of others, which, on reflection, is really very sad in a leader, and a little scary in a president.”

Scary and shallow. Sociopathic and terrifying. There may not be anything else.



About Facebook


It’s been a rough couple of years for Mark Zuckerberg. From bots running amok to carefully assembled fake news to Cambridge Analytica acquiring the personal data troves of Facebook users, the platform is being regarded as the evil empire in a whole new way. 

In less than two weeks, Facebook saw its stock drop $90 billion – almost 20 percent of its value. The Federal Trade Commission is investigating the company, and Zuckerberg has been summoned by lawmakers in the US and Britain to respond to allegations that Facebook shared user data without permission.

You must admit that all this is at least mildly unsettling. Those friends of yours who stayed away from social media due to what seemed like borderline paranoia suddenly don’t look so unreasonable.

It’s a fact – if we’re on the internet we’re being tracked, by multiple tech companies that may share user information. That was clear long before the Facebook scandals unfolded. And as many of us at least consider the question if continued participation on Facebook is worth it, I’d like to say that I believe it is; that young Mr. Zuckerberg and his associates run an enterprise that may require some reigning-in but ultimately operates with significant public benefit in addition to obscene profits (It’s now believed to be the sixth most valuable property in the world).


Mark Zuckerberg and Facebook are under the magnifying glass.

If you’re reading this chances are you know that I’m somewhat active on Facebook. I found it immediately suitable for my personality – limited attention span, easier to write than talk about what I think. The page offers something for everyone. If you would rather lurk than post, well, there is plenty of opportunity for that.

Very simply, Facebook connects people. While some say it plays on our insecurities and narcissism–and they may have a point–the platform is helpful in numerous ways. It enriches the lives of those who embrace it for that purpose.

If you have a special interest or hobby, there is probably a Facebook page for it. I follow pages regarding music I like, important healthcare topics, Dodger baseball, old album covers, former employers, and schools I have attended, among many other subjects. I have met (at least virtually) hundreds of people I might not otherwise know, and the fact that we haven’t encountered each other face-to-face doesn’t mean I don’t care about them and–hopefully–vice-versa. And when it comes to the people I have encountered, whether meeting them for the first time or not, I have found a warmth and familiarity that might have taken awhile to achieve otherwise. This has turned out to be especially true at school reunions. The platform provides opportunities to join virtual communities, and we’re generally better for it.

However, we may now feel that our trust has been violated, and one reason why is that it seems Zuckerberg promised nine years ago not to sell the data of his users.

Facebook could be approaching a crossroads. Its current business model depends on selling the data it collects from our activities on the platform, despite Zuckerberg’s 2009 remarks. That’s a major reason why it’s free. Going forward, the company may be more transparent about that upfront, because a lot of people have been surprised by it, although they probably shouldn’t have been. But then again, there’s that video. Maybe we’ll see the model evolve to a place where users have a choice – pay a subscription fee or agree to have their data sold. I think I’d choose a fee, within reason.

In the meantime, I’m staying, and hoping that smarter people than me can put their heads together and fix what ails Facebook.

Where the music was


One of the Facebook pages I follow recently featured a comment from someone definitively stating that 1972 was the best year for music. Unfortunately, when I asked him why he believed that (a truly honest question – I wasn’t looking to argue), his response wasn’t particularly illuminating.

The exchange stayed with me. What was the best year for music? Is there a more subjective question? Probably not – but I’m going to try to tackle it, anyway, and justify my answer.  I’m also going to cop-out.

While the 70s were absolutely dynamic musically–including 1972–and brought us a massive trove of great songs that have held up very well, I believe that 1966-1969 was the golden age of modern pop music, and that it’s very difficult–if not impossible–to distinguish a “best” year among them.

Even though a sizable portion of music from that time was psychedelia that hasn’t aged gracefully (in my humble opinion), the best of it was groundbreaking and set the table for everything that followed in the same way Buddy Holly, Little Richard, Elvis, Carl Perkins and Chuck Berry gave birth to the early years of Rock-and-Roll.

This four-year period spawned legend after legend – impacts still being discussed and debated 50 years later. I have boiled my examples down to 16.

  1. The Beatles revolutionized the revolution – The Fab Four weren’t content with what they started in 1963-’64. In ’66 they stopped touring and closed out their career as a band with stunning flurry of meticulously-produced albums that explored every style, starting with Revolver and concluding with the epic medley on side-two of Abbey Road in 1969. The rest of the music world attempted to keep up, and the best artists did.
  2. Dylan went electric – The hero of 60s folk pissed-off the nation’s coffee houses by adding electric instruments in concert, often eliciting boos. He followed with a 1966 album that kept pace, Blonde on Blonde – still thought by many to be his best work.
  3. The Rolling Stones began to hit their peak – The Stones saw the ante being upped and responded with the albums Let it Bleed (1968) and Beggars Banquet (’69), and some of their greatest songs – Honky Tonk Woman, Let’s Spend the Night Together, Jumpin’ Jack Flash, Paint it Black, Monkey Man, Gimme Shelter, Sympathy for the Devil, and You Can’t Always Get What You Want.    
  4. The deification of Clapton – Graffiti began to appear around London in the 60s saying, “Clapton is God.” He was/is one hell of a guitar player, that’s for sure. In 1966 he joined Cream with drummer Ginger Baker and bassist Jack Bruce. It was considered Rock’s first supergroup if you don’t count the Beatles. Cream didn’t last long, disbanding in ’69 and leaving us with classic blues-rockers like Strange Brew, Sunshine of Your Love and White Room. From there Clapton joined another supergroup, Blind Faith, with Baker and Steve Winwood.       
  5. The Jimi Hendrix explosion –  The authentic shooting star of Rock-and-Roll. Jimi arrived in London in ’66 and turned Rock on its ear for the remainder of his too-short life. His guitar virtuosity and unique sound made him a must-see for the Beatles and other inhabitants of Swinging London, and he made Clapton seem mortal.
  6. Brian Wilson raised the bar – The story goes that Wilson heard the Beatles’ Rubber Soul in ’65 and led the Beach Boys into the age of studio complexity and perfectionism to produce Pet Sounds in ’66, and that the Beatles heard it and–already committed to deeper studio craft–were driven to create Revolver and Sgt. Pepper’s Lonely Hearts Club Band. Pet Sounds took a teen-idol surf band into the realm of progressive modern music. After that Wilson returned to the studio to produce what is probably the band’s greatest song, Good Vibrations.
  7. Tommy can you hear me? The Who seemed to be operating just outside the inner circle of the British Invasion when Pete Townshend changed all that by inventing the rock opera with the album “Tommy” in 1969. That deaf, dumb and blind kid sure played a mean pinball.
  8. The arrival of Led Zeppelin – Jimmy Page found a singer for the ages in Robert Plant and an innovative style of blues-rock/hard rock was born. It’s interesting that neither man has found much success by themselves. But that band had an alchemy that captivated the world and produced a body of work that should stand up for decades. It all began with two albums (I and II) in 1969 and, specifically, this cut to open the first LP.

9. The Band ignited a genre – Five guys who backed Bob Dylan on tour before venturing out as the Band delivered two pioneering works of Americana – their 1968 debut, Music from Big Pink, and a self-titled follow-up in ’69. Musicians were particularly enamored with the Band–Eric Clapton once said they changed his life– and the Eagles and much of modern country music owe the group a big debt of gratitude.

10. The astral plane – George Ivan Morrison, 23, previously known as the front man for the R&B-tinged Them and writer/performer of the wickedly catchy Brown-Eyed Girl, confounded everyone with an ethereal work of genius, 1968’s Astral Weeks. Folk-jazz is the closest description of the songs on this album. Van has spent the rest of his legendary career both playing it up and trying to live it down. He has produced other albums that are just as good, if not better, but nothing as unique for its time as that.     

11. Jerry’s Kids – The lead guitarist was missing most of a finger (Jerry Garcia), the rhythm guitarist (Bob Weir) joined the band because he didn’t have anything else to do, and the Warlocks morphed into the Grateful Dead and released its first iconic live record, Live Dead, in 1969, unleashing a 25-year gypsy caravan of music and ritual that ended only with Garcia’s death. Volkswagen buses never had it so good.

12. R&B got down and gritty – The Queen of Soul just crushed it. Check out Aretha Franklin’s Greatest Hits (1967) for a setting of the bar that remains formidable in 2018. Otis Redding, sometimes considered the King of Soul, left us too soon, in ’67, but his memory remains through a trio of tremendous albums released from ’66 -’68, Dictionary of Soul, the Dock of the Bay, and King and Queen. An innovative little outfit from Vallejo, CA–Sly and the Family Stone–erupted on the scene in ’68 with the songs Dance to the Music and Everyday People. Wilson Pickett continued to build on his crossover stardom with Mustang Sally in ’66. And Marvin Gaye made important strides during this period, recording I Heard it Through the Grapevine in ’68 and following a path that led to his seminal work, What’s Going On, in the early seventies.

13. Country – Buck Owens of Hee-Haw fame was emerging in 1966 with the harder-edged Bakersfield Sound, adopted faithfully and effectively by Merle Haggard and Dwight Yoakam; and the Byrds, of all bands, took another step to fuse rock and country with its Graham Parsons-led Sweetheart of the Rodeo in ’68. Johnny Cash and Glen Campbell were so mainstream that each had their own network variety shows beginning in ’69

14. The Chicago Transit Authority – Rock, Jazz and R&B intersected here with this band–we know it now, of course, as Chicago–and its self-titled debut album in 1969. The group has traveled a number of different directions in the last 49 years, but its early moments were breathtaking and arguably paved the way for the more sophisticated sounds of Steely Dan several years later.

15. Loan Me a Dime – A Texan named Boz Scaggs was already refusing to be typecast when he recorded this 12:30 instant blues classic on a self-titled album in 1969. His unique brand of blue-eyed soul would continue to develop through the 70s, culminating with the career-topping Silk Degrees. Nearly 50 years later Boz still plays Loan Me a Dime in concert.


16. Breaking through – Crosby, Stills & Nash caught fire with its debut album in 1969, helping to usher-in the so-called Southern California sound with a stunning song called Suite: Judy Blue Eyes; Neil Young’s second album, Everybody Knows This is Nowhere (’69), established his classic Crazy Horse sound; Three Dog Night arrived on the scene in ’68 with one of its biggest hits, One, from the band’s self-titled debut album; Linda Ronstadt debuted with Hand Sown..Home Grown (’69); and Alice Cooper debuted with Pretties For You in ’69, testing out some of the themes that would make him a pioneer of shock rock.

Other classic artists that flourished between 1966 and 1969 included the Doors, Janis Joplin, Traffic, Jefferson Airplane, the Mamas and Papas, Simon and Garfunkel, and Creedence Clearwater Revival.

As for 1972, it was no doubt a very good year, with the ascension of Elton and Bowie and the Eagles and Cat Stevens–among others–already underway, but it might have fallen a little short of any of the last four years of the 60s.




Healthcare from Hell


What can you say about the high-speed train wreck that is American healthcare that hasn’t already been said? Perhaps nothing, but there are plenty of stories out there to talk about; a number of truly distressing examples that should be pointed out repeatedly as reminders to us all that this system is deeply diseased.

Late last year in Marina, CA my sister and brother-in-law responded to a terrible commotion on their patio and found a raccoon attacking their two small dogs. When they stepped in to break it up the raccoon was undeterred and bit them. A trip to the emergency room followed and then they underwent a series of rabies shots, which was the most painful development of all, and not for the reason you might think – they were presented with a bill for $10,000. They have medical coverage, of course, a solid school district policy through my sister’s teaching job, but it didn’t cover the full cost of the rabies series for two people – an eye-popping $90,000. This is hardly an elective procedure, as you probably know. Rabies is 100 percent fatal.

An article on this very treatment appeared recently in Vox, pointing out that the high cost is due to a drug called immunoglobulin. US emergency rooms charge up-to $10,000 for a single dose. In the UK they charge $1,600. “Rabies treatment is more expensive in the United States, as are many medical treatments, because we don’t have price controls,” according to Charles Rupprecht, a biomedical consultant who previously ran the rabies control program at the Centers for Disease Control and Prevention, as quoted in the Vox piece.

My sister told me another story recently – about a man she knows who needed surgery for prostate cancer, but he was unemployed and his COBRA plan wouldn’t cover it. A local hospital wouldn’t perform the surgery without an $5,000 payment up front, money he didn’t have. So he was forced to establish a GoFundMe page to raise the cash required for an operation to save his life.

It’s a time of staggering irony in modern medicine – never has it been more scientifically advanced, more technologically remarkable; and never has it been so abjectly ridiculous. While much of the rest of the first world cares for its citizens through some form of universal approach (more later), the United States of America, arguably still the greatest country in the world, defers to the whims of insurance companies, pharmaceutical companies, CEOs and shareholders, and we all pay the price.

My mother is 83 years old and, unfortunately, in declining health. The American medical industry has responded with prescriptions – you know, better living through chemistry and all that. It turns out there is quite a lot of chemistry. She takes 23 pills every day. We–her children–have attempted to engage her doctors in some analysis of what is actually effective and what may be potentially harming her through interactions with other medications. But we haven’t had much success.

According to a web site called Statista, The United States alone holds over 45 percent of the global pharmaceutical market. In 2016 this share was valued at about $446 billion, with six out of the top 10 companies from the US. $446 billion buys a lot of lobbyists on Capitol Hill and, as we have all seen, a slew of expensive TV advertising for drugs that may or not be helpful but are likely profitable. An example is the anti-depressant Abilify, which can lead to coma or death.


Abilify may not be for you.

The legendary Steve Martin spoofed the absurdity of drug company disclaimers 20 years ago in an essay he wrote for the New Yorker called “Side Effects.” Here’s an excerpt:

Do not consume alcohol while taking this pill; likewise, avoid red meat, shellfish, and vegetables. O.K. foods: flounder. Under no circumstances eat yak. Men can expect painful urination while sitting, especially if the penis is caught between the toilet seat and the bowl. Projectile vomiting is common in thirty per cent of users-sorry, fifty per cent. If you undergo disorienting nausea accompanied by migraine and raspy breathing, double the dosage. Leg cramps are to be expected; one knee-buckler per day is normal. Bowel movements may become frequent-in fact, every ten minutes. If bowel movements become greater than twelve per hour, consult your doctor, or any doctor, or just anyone who will speak to you.  

Insurance companies are seen as the other major villain in this train wreck. The stories of denied coverage and counterintuitive explanations are legendary, and have been for decades. We all seem to have first-hand experience with it or know someone who has. The state of California recently launched a probe of Aetna after after learning that a former medical director for the insurer admitted under oath he never looked at patients’ records when deciding whether to approve or deny care. While that statement isn’t necessarily surprising, the fact that someone would be put in a position to have to admit it is unusual, and it’s quite welcome.

A story developed several weeks ago about a 51-year old self-employed New England carpenter who won a $1 million lottery prize and was looking forward to squirreling some money away for retirement, buying a new truck, and relaxing a little. Turns out he he didn’t have medical insurance–couldn’t afford it–so he used some of the money for a long-overdue trip to a doctor, where he learned he had stage-four cancer. He died less than a month after cashing the ticket.

Yep, health insurance is messed up. I take three medications daily and like just about everyone else refill my prescriptions monthly. My co-pay is $1.62, not each but in total. I could certainly afford a much higher co-pay and would be more than willing if it meant that people like that carpenter could afford health insurance and therefore see a doctor regularly, and my sister and brother-in-law didn’t have to deal with a bill of 10-grand for life-saving treatment, and my chronically-allergic wife, who has been treated several times to prevent attacks of anaphylactic shock, doesn’t have to face the prospect of paying several hundred dollars for shots of epinephrine she carries with her in devices commonly called Epipens, because insurance coverage has slackened as prices have dramatically increased.

In 2007, according to Business Insider, a pharmaceutical company called Mylan acquired the rights to produce Epipens. The story points out that at the time pharmacies were being charged less than $100 for a two-pen set. Then annual price hikes set in – peaking every year in August, when parents of children with severe allergies typically stock up on Epipens for use in schools. In 2016, the price reached $608.61 – an increase of more than 500 percent over a decade. And that eventually landed Mylan CEO Heather Bresch in front of a House oversight committee, facing uncomfortable questions. Before long, though, the problem had taken care of itself, as lower-priced competitors surfaced, including “Adrenaclick,” a $10 Epipen alternative. Mylan has seen its market share plummet. As far as my wife is concerned, we still must navigate the doctor-pharmacist thicket to try to secure one of those alternatives, be it Adrenaclick or something else.


I have a small side complaint about signs like these at doctors’ office and pharmacies – nothing about this arrangement protects privacy as long as people can talk.

The slow-burn journey through the bureaucracy we will surely face will help us prepare for the next phase of our lives – membership in the Medicare generation. It’s government health insurance when you’re 65, unless you’re still working, and–of course–it’s not complete coverage. You’re gonna need another policy on top of that and probably still pay out of pocket. Here’s the AARP, attempting to explain:  “Depending on which (Medicare) plan you choose, you may have to share in the cost of your care by paying premiums, deductibles, copayments and coinsurance. The amount of some of these payments can change from year to year.

“Most people who qualify for Medicare don’t pay a monthly premium for Part A, but they do pay premiums for Part B and Part D or a Medicare Advantage plan.”

Ok, parts A, B and D; WTF? Well, Medicare is helpfully separated into sections, including a part C. Again, the AARP explains:

  • Part A (hospital insurance) helps pay for the costs of inpatient stays in hospitals and short-term skilled nursing facilities, home health services and hospice care.
  • Part B (medical insurance) helps pay for doctors’ services (including those in the hospital), outpatient care, preventive care, and some medical equipment and supplies.
  • Part C (Medicare Advantage) is an alternative coverage option to original Medicare that allows you to receive all of your Medicare benefits through one plan. Medicare Advantage plans (typically HMOs or PPOs) must cover all of Part A and Part B services, and most plans include Part D prescription drug coverage in their benefit packages. Some plans provide extra services that original Medicare doesn’t cover. 
  • Part D helps cover the cost of outpatient prescription drugs. 

The AARP advises that if Medicare patients have questions, they can contact Medicare, or the Social Security Administration–which administers a piece of the program–or something called State Insurance Assistance Programs (SHIPs). Does all this seem confusing? Yes, I would venture to say it does, even more than the convoluted system that holds those of us under 65 captive. As we get older and seek more simplified lives, American healthcare vexes us by funneling us into a system that is anything but simple.

T stupidity

Into this abyss plunged guess who? Yep, the infantile Donald J. Trump. Following his improbable election his first order of business was to attempt to un-do the Affordable Care Act, or Obamacare, for the sole reason that it was an achievement of President Obama’s.  After several tries he finally managed to convince Congress to put some provisions in place, to predictable effect. A recent story in the Los Angeles Times stated, “Those fiscal geniuses in the White House and Republican-controlled Congress have managed to do the impossible: Their sabotage of the Affordable Care Act will lead to 6.4 million fewer Americans with health insurance, while the federal bill for coverage rises by some $33 billion per year.” 


Most of the other developed nations of the world have some type of universal health care – places like the UK (and much of the rest of Europe), Canada, Australia and Japan.  Imagine how this madness looks to them. Well, we actually have some idea, thanks to the Internet. I pulled this example from a friend’s Facebook page:

“Whilst living in the States, my 3yr old daughter was jumping on the bed (despite many warnings not to) Naturally, she fell off and knocked herself out. She was unconscious for a few seconds (which felt like years) and after a frantic 911 call, two ambulances, a firetruck(!) and a police car showed up. They strapped her to a back board and then….something weird happened. The ambulance guy turns to me and says “do you want us to take her to hospital in the ambulance?” “Err…yeah” I replied, thinking, is he cracked? What else would you be doing with her? Off we went with me beside her & my husband following. All checked out well.
Two weeks later a bill drops on the mat for $835 – for the ambulance. I call up to explain that there’s been a mistake, we have insurance, etc,. “No” says the lady on the line, “that’s not covered by your insurance” (we had the gold-standard- armour-plated one).
Apparently, an ambulance ride is viewed as a separate cost that many insurers don’t cover. It defies belief, it really does. We were so glad to move back to the UK – warts and all, it’s a much fairer society. Altho’ the Tories would rather it wasn’t. This is the reality.”

Meanwhile, in the Canadian province of Quebec, more than 700 medical professionals, mostly doctors, are protesting planned pay raises. They’re asking their employers to hold them back for the good of the entire health system. The doctors feel they already make enough money. The average salary for a physician in Canada is $260,000.

If all this isn’t enough, consider the American opioid crisis. According to the Atlantic, in 2012 there were 793 million doses of opioids prescribed in the state of Ohio, enough to supply every man, woman, and child, with 68 pills each. Roughly 20 percent of the state’s population was prescribed an opioid in 2016. Ohio leads the nation in overdose deaths. Reasonable questions are being asked: Are drug companies pushing opioids on people by shipping huge quantities to areas with population sizes that make no sense for the quantity of drugs? Why haven’t crack downs on these companies worked? Have there been been crack downs? Some public officials are trying. Ohio has joined a handful of other states suing pharmaceutical companies for spending millions on marketing campaigns that allegedly trivialize the risks of opioids while overstating the benefits of using them for chronic pain. The companies allegedly lobbied doctors to influence their opinions about the safety of the drugs. Additionally, some of the latest research indicates that opioids are not more effective long-term painkillers than other medications like over-the-counter acetaminophen and and prescription lidocaine. The cause is believed to be a built-up tolerance to opioids, a development that helps feed addiction and keeps the gravy train rolling.

American physicians apparently get a piece, too. A joint study by CNN and Harvard found that in 2014 and 2015, opioid manufacturers paid hundreds of doctors across the country six-figure sums for speaking, consulting and other services. Thousands of other doctors were paid over $25,000 during that time. Physicians who prescribed particularly large amounts of the drugs were the most likely to get paid. Can you say bribery?

It is, of course, no surprise that when Trump recently called for executions as a mitigating measure in the opioid crisis, he wasn’t talking about CEOs of pharamceutical companies.

America is broken. Its healthcare system is a major symptom. So is its president.







Tourists in the homeland


My wife and I grew up in Southern California–metropolitan LA–and we each left more than 35 years ago. When we go back we find we’re flooded with memories while also feeling like we’re visiting a strange land.

Calling LA the homeland is, of course, a little misleading. The Los Angeles Basin is so vast that it encompasses a number of distinct areas that could be considered homelands. I hail from the mostly working-class San Gabriel Valley, and my wife lived in the more prosperous hills above the San Fernando Valley. So our recent trip to West LA was much closer to her youthful experiences than mine.

I have often thought if I had grown up on the west side–with its urbanity, glamour and coastal access–I may never have left. But I’m not sure of that anymore. It’s all too big; too crowded. I have come to remember that was pretty much the case all those years ago, and it was one of the reasons I left in the first place. Here are some other observations from our tourist jaunt:

1) Traffic ruins your life – Even though we managed to avoid a life-altering experience on the San Diego Freeway (the 405), the busiest highway in America, we spent more time in cars than at any other activity except sleep. Drives to Santa Monica and Malibu, relatively close locations, were marred by gridlock. A seven-mile trip between two points on Wilshire Blvd. took 45 minutes, even with our Lyft driver functioning at peak creativity with short cuts on side streets. On our last day in town, as we pointed our rental car in the direction of the airport at Burbank, we allowed ourselves enough time to stop at a Target in West Hollywood, or so we thought. It was four-and-a-half miles from our West LA hotel, and it took us an hour-and-15 minutes to get there. We ended up not going in and slogging straight through to the airport. The only reason we made it with a comfortable amount of time to spare was a flight delay.

2)  Traffic signals and road signs need updating – LA has more than four-million people, more than two-million vehicles, and not nearly enough left-turn signals at intersections. That’s one reason it takes so long to drive places. And the road signage is confusing, at best. I managed to get lost along major thoroughfares like Santa Monica Blvd. and Coldwater Canyon Dr., even though I possess some actual skill when it comes to navigation in unfamiliar places. And yes, I looked at maps.


3) Drivers are quite good – Unlike Sacramento, where drivers are unpredictable and road rage always a possibility, the LA drivers we encountered were decisive and polite. They use their blinkers and will generally make room for you to crowd-in someplace. But they’re also super-aggressive and a little impatient. They have lots of practice navaigating through the muck, so they won’t hesitate to lean on their horns if you seem confused.

4) Walking in LA – When the band Missing Persons claimed in song years ago that “only a nobody walks in LA,” they probably weren’t talking about Beverly Hills. The downtown core is quite walkable and plenty of people are moving about on foot. You probably have to drive in, though. The same is true for the coastal strip of Santa Monica.

5) Everybody seems to have a plan and an attitude – But they’re often good attitudes, probably because folks are hustling. West LA is one of those places where lots of people are chasing a dream. One of our Lyft drivers said she was a London-trained stage actress. I met a young man in a bar in Koreatown who was probably half my age, well-dressed and stylishly-coiffed, and positively brimming with enthusiasm. He claimed he went to Stanford, had been a golf pro, and promised to run for governor in the future. But he was in a hotel bar at 4:30 on a Monday afternoon. After our 10-minute chat he insisted on the thumbs-up handshake and half-bro hug I see my son employ all the time. It was a first for me.

6) People are welcoming and curious – Probably because they’re wondering if you can do something for them. Our bartender the night we hung out at the Sunset Marquis hotel in West Hollywood must have taken one look at me and known I wasn’t one of her usual Rock-and-Roll clientele, but she was nonetheless very friendly and can-do. Just about everywhere we went, including the legendary Nate and Al Delicatessen in Beverly Hills, we were studied intently by people trying to figure out if we were someone they should know. And when they determined the answer was no they stopped looking at us.

7) Concertgoers are rude – We went to a pair of Van Morrison shows in West LA, and the crowd behavior was very disappointing. Too many people were acting like they might have at a Foghat concert 40 years ago at the Forum. There was far too much drinking and loud talking, and people were constantly in and out of their seats. Van is an artist who requires rapt attention – he is truly a European old master. I find it hard to believe the LA crowd would have acted similarly if they were seeing the Three Tenors, or Leonard Cohen, or Sinatra. Yet they felt it was appropriate in this case. As we left the venue frustrated after the second night we walked past a young woman complaining to her friends that she was shushed during the show. My wife and I said, “Good” in unison, loudly enough for her to hear us.

So those were some noteworthy moments during our trip. LA is definitely fascinating – a vibrant international destination and center of art and commerce perched on a fault that could one day grind it to ruins. But the gleaming megalopolis presses on, all optimism and sunshine – 284 days a year. I’m reminded of an episode of ‘Seinfeld’ in which the character Cosmo Kramer said of LA, “She’s a seductress, she’s a siren, she’s a virgin, she’s a whore!” He’s probably right about that. Los Angeles, the mythical Hotel California, is a helluva place to visit and–with apologies to Mr. Don Henley and the late Mr. Glenn Frey–you can in fact leave, and that’s a good thing.

thumbnail (2)