Category: 2010 and Beyond

My average morning includes sifting through a couple hundred emails. If I turn off the computer by 11 PM, I will have over two hundred emails waiting for me the following morning.   A week or so ago, I began my work day the way I usually do – I started the coffee, turned up the music, and checked my emails. One email caught my attention. The prettiest girl in Parma had sent me a message. It had only been a couple of weeks since I had revamped her health policy, so I immediately knew the purpose of this email. Yes, her account had been hacked.

Email, Facebook, Twitter, we have too much access but not enough interaction. I feel compelled to respond to every contact. I compulsively answer every question. If someone sends me an email, I respond by email. Sometimes the message is nothing more than an acknowledgement of receipt of their email. Some friends and clients correspond primarily through Facebook. OK. I respond in kind. Phone calls? More personal so less common in 2014. But the people who take for granted that I will answer their questions, listen to their concerns, or simply point them in the right direction, often feel no need to respond to me. Did I answer your question? Do we need to meet? To talk? Are you still there?

Most of the emails I receive are either spam or sales pitches. I have become surprisingly adept at eliminating them. I have to be careful that I don’t inadvertently delete a legitimate email while dumping the trash. It takes the hand – eye coordination of a .300 hitter to weed through them as quickly as I do now. But every click brings to mind how great it would be if this In Box were filled with meaningful notes from people who actually wanted to talk with me. But it isn’t. There are three emails from the guy whose food will save my life and countless opportunities to check or improve my credit score.

Facebook has, in an odd sort of way, become more enjoyable. The pictures, children, grandchildren, and the pets, lots and lots of pets, seem to be more genuine and the emotions seem more real. I’ve seen countless pictures of my friend, Mirja, with her cat. I really hope that Cleo, the cat (pictured above), loves Mirja half as much as she loves it. And my friend Ellen just posted a new studio picture of her with all of her grandchildren. We, her Facebook friends, get to watch them as they grow up and share in her joy.

A new trend has popped up on Facebook. Tired of trying for mass appeal, I have seen people start to segregate their FB friends. Some posts go to everyone. Pictures of the kids and noncontroversial posts about TV shows are there for everyone. But the good stuff, the posts that give a hint to the person behind the name and safe picture, only goes to a select few. Who knew that L.C. was so adamantly an atheist? When did S.S. become a liberal Democrat? Was J.W. always that conservative? And now, instead of risking offending some of their friends, or worse, pretending to be without beliefs or opinions, they created their own communities. New friendships, built on more information and a lot more honesty, might actually become real friends.

Will it take hold? Will these new communities just be more fodder for Facebook’s insatiable need for more info so that it can sell our data to more advertisers? I don’t know, but I enjoy the new found clarity and sense the freedom that pretenses kept hidden.

I teased the prettiest girl in Parma that even a hacked email from her is better than nothing. She agreed that we should talk more often.

 

 The master of the house breaks the middle matzah in the plate, and leaving half of it there, he puts aside the other half till after supper, for the Afikoman.  

Those of you who have ever attended a Passover Seder recognize this as Yackatz, the fourth step in the retelling of the Exodus from Egypt. There are several lessons to be learned in this particular portion of the Seder. One of the most important is that some slaves, the Children of Israel, ate a portion of their rations when it was given to them and retained the rest for later. These smarter slaves, these survivors, are our ancestors.

The Seder can not end until we eat that other half of matzah. Years ago, when my children were small, I would hide the Afikoman. The kids, mine and the children of my friends who were in attendance, would do a mad dash through the house looking for the napkin holding the matzah. I was tricky. I even planted fake Afikoman, napkins with notes that said that they needed to continue looking. Bookshelves, piano benches, behind the couch – it could be anywhere. And when it was found there were prizes for everyone.

And then the kids got too big. Their searching could have been detrimental to the bookshelves, the piano bench, etc… And so we created a new tradition. Someone would take the Afikoman when I wasn’t looking. Eventually it would be returned and there would be prizes for everyone.

Now I don’t share this story with you out of some desire to recreate the past. I don’t. I remember fondly different houses, blended families, and the children of friends that are long past childhood. And those are moments in time that I will always cherish. The last two nights have been our annual Seders, and it would be odd to not reflect upon nearly fifty years of creating and recreating traditions in the service of a bigger truth.  

My parents gladly ceded the Seder to me as soon as I asked to be in charge of it. Second grade. Not their thing. Growing up the Afikoman, and all of the Seder from Page 4 to Page 28 of the Haggadah was simply something I had to get through before everyone lost their patience. The Four Questions, the Four Sons, Spill the 10 drops of wine “DON’T MAKE A MESS”, Wash your hands a couple of times, and then it was time for dinner. Why was Passover my favorite holiday? Surely not because of the Seder. I found the story compelling.

I found it interesting that the Children of Israel had to actually do something. They were forced to choose to be part of a community.

I had limited exposure to other Seders while growing up. I’m sure we went to others, but I don’t recall any specifics. But 40 years ago, Passover 1974, I was invited to spend the first two days of Passover with a Rabbi and his family in Wooster, Ohio. Though the Seders were in his home, there would be a large cross-section of the community in attendance. Congregants, relatives, non-Jews. There were well over twenty people crammed into their home. I ate different foods. One lamb dish, in particular, blew me away. And I learned that you could smoke throughout a Seder. (The Rabbi and I weren’t the only ones who smoked, we just looked the happiest. Remember it was 1974.)

Somehow I ended up with the Afikoman and when I returned it, he asked me for my terms. There was a ransom involved. I was unprepared.  Thinking quickly, I handed him the Afikoman, and said that I would reserve my reward for a later time. Now he was as surprised as I had been moments earlier. I heard the murmur of a couple dozen people wondering what would happen next. They were shocked by the audacity of this long-haired, bearded teenager. The Rabbi thought for a moment and then said that he would agree to my request and we all shared in the last of the matzah.

A few weeks later I met privately with the Rabbi. He was in Cleveland for the Brit of his first grandson. I told him that I was ready to discuss the Afikoman. My ransom? I asked for his blessing to marry his daughter. His blessing, but not his permission. He appreciated my choice of words and the respect that they carried for him, his daughter, and for our traditions. He readily agreed.

That was a long time ago. Many traditions have been created and set aside in forty years. But Passover will always be my favorite holiday, the Seder I lead uniquely mine, and the traditions kept and the stories told have been passed on to my children and our friends to modify as they see fit.

And it all works as long as you remember to finish the Seder with the Afikoman.

Yes, I have been working ridiculous hours since October, but the time has not been spent without certain rewards.  The best, what has really made this worthwhile is the cast of characters that have passed through my gates.  Here are a couple of visitors from just the last week or so.

“My house is haunted.”  She dropped that sentence apropos of nothing.  There was neither a hint of irony nor humor.  If I had said it, anywhere, I would have met a certain amount of derision, or worse.  But a beautiful woman can earnestly say just about anything.  Without missing a beat I asked, “Is that a good thing or a bad thing?”  She said that it was a problem at first, but that she’s OK with it now.  When asked if she was planning to move, she said that she didn’t know…

He was the world’s least interesting man and he took what seemed to be three hours in my office to prove it.

Defiant, the woman sitting at the table had been engaged in a war that had lasted over four long years.  And she had won.  She wasn’t ready to declare victory.  She was still prepared to fight.  And that was all of the proof I needed.  She was never really a victim, just someone who had been forced to overcome crippling personal and financial setbacks that might have defeated a weaker spirit.  I needed her email password.  She told me that it was F***You62.  And I laughed.

I was visited by a queen in search of a king.  Sure, there are people who say that they believe in the fairy tale, but how many of us will truly dedicate ourselves to achieving it?  Sadly, not many.  Too much work.  Too much commitment.  That was not the case with this woman.  And no, she wasn’t in search of financial security.  She was climbing Maslow’s Hierarchy of Needs and was shocked to learn, again and again, that she was alone.  She wanted completeness, the whole package.  They, ex-lovers and an ex-spouse, were revealed to have only wanted the company of a pretty girl.

I learned the strength and resilience of the human spirit from these clients and others over the last few months.  I saw that nothing, not ghosts, not bad employers, not even the death of a loved one can’t be overcome in time.  And I learned to believe in fairy tales.

The cover of Time Magazine features the team that fixed HealthCare.gov, the Eighty Percenters.  I know.  I know.  Officially, HealthCare.gov has been completely fixed and everything is copasetic.  And if you ignore the crashes, the glitches that send people to Medicaid, and the general weirdness, then the only real issues are that it is a clunky, repetitive process that makes it difficult to select an insurance policy and has no way to collect the initial premium payment.  Damn near perfect.

It takes five minutes to complete the brain-dead, anyone can do it application for a non-subsidized, off-exchange policy.  I allocate an hour and a half to enroll someone on the government’s website.  An hour and a half!  And if we are lucky, it will only take one try.  We are learning to flinch.  We prepare ourselves, and our clients, for failure before we even bother to create their password.

Taking a toll on our community

A young woman returned to my office Monday evening for our shot at the exchange.  I spent over a half hour prepping for the exchange.  Not once did we discuss insurance or insurance products.  We then went into the system and zipped through it in less than an hour.  When we hit the last button, an action that has too often led to incredible frustration, and her application went through, it was so easy that I had to look closely to verify success.  I was more prepared for failure.  The client, a massage therapist at the Cleveland Clinic, was surprised by the knots in my shoulders and neck.  I could use a deep tissue massage daily. 

And I am not alone.

Meeting with my peers I have noticed elevated levels of frustration and agitation.  “Did you hear that the President moved back the enrollment deadline in 2015 to February 15^th?”  “Well yesterday the Health and Human Services issued new rules.  Looks like you may be able to keep the old policies a little longer!”  The rules change every day.  And once the feds make a change, then the states have to react. And then the insurers react.  And then we get to explain to our clients how all of this affects them.  Or not.

You can’t call it PTSD, Post-Traumatic Stress Disorder, because we are still in the middle of it.  The open enrollment ends March 31^st.  Somewhere in mid-April we will learn new rules of engagement for the balance of 2014.  By mid to late summer we will begin the process to recertify for the exchanges and senior products.  And sometime in late summer or early fall, we will find out if all of the old policies, the coverage most of you have, will be allowed to continue or if everyone will be forced to have PPACA (Patient Protection and Affordable Care Act or Obamacare) compliant policies for 2015.

Clients want answers now.  We look like idiots when we can’t answer all of their questions.  But we can’t. The agents, an afterthought in the sweeping change that is the PPACA, turned out to be very important.  The insurers are just as overwhelmed.  Some of my Home Office contacts divide their time between issuing apologies and putting out fires.  They aren’t being paid nearly enough for the abuse they are taking.

I took yesterday morning off.  Slept late.  Read the Plain Dealer with a cup of coffee.  Hell, I didn’t get to the office until 9:15.  Positively Decadent.  No, we are swamped.  Working too hard for success.  Encountering way too many failures.  Learning to flinch.

 

We spent a week last month in Punta Cana.  The daily high in the Dominican Republic was a reliable 80 – 85 degrees.  Even the evenings were warm and pleasant.  We were surprised, however, by the plane-load of Russians that were staying at the resort.  These weren’t Russians who now live in Cleveland or Russians who now live in Philadelphia.  No, these were Russian – Russians.  Muscovites!  It certainly added to our trip.  We noticed that the women were very attractive.  Some drop-dead gorgeous.  The men were big.  Huge.  And Russian T-shirts come in only one size – Almost. 

Jeff and I had lunch at Shuhei on Tuesday to celebrate our birthday.  And yes, it does seem a little strange having the same date of birth as my business partner.  Not just birthday, date of birth.  We were born a few hours apart on February 4, 1955.  It is a bit like having a twin.  There just isn’t any of that creepy “I know what you’re thinking” stuff. 

I will spare you the math.  We just turned 59.  But no one is 59.  Saying that you’re 59 is a bit too precise, like a child proclaiming that he is 4 ½.  We’re not 59.  We are almost 60. 

I used to know what 60 looked like.  It looked OLD.  Now, not so much.  Maybe just almost old.  Jeff has had a hip replacement.  I have a vacant spot on the top of my head that was once covered with hair.  So sure, we’re older, but we aren’t old. 

This is the sixth year of Barack Obama’s presidency.  The mid-terms are in November and once we are past the election we begin the 2016 campaign.  Mr. Obama’s term, for good or ill, may run till January 20, 2017, but in truth, it effectively ends with the beginning of the serious campaigning in the summer of 2015.  So this year, 2014, it is almost over.  What is really important?  What is worth one last push?  Immigration?  The Minimum Wage?  Afghanistan?  Pick one and follow through Mr. President.  You don’t have much time left. 

The Pentagon spent a lot of money to develop the Neutron Bomb, a device that was designed to kill lots of people, but to do as little damage as possible to buildings and structures.  We are now six years into a neutron recession.  The stock market is at an all-time high and so are the numbers of unemployed and underemployed Americans.  Will this be the year of our recovery?  Will we finally climb out of this economic quick sand and stand on firm ground?  

I don’t think so.  I think that this is the year of Almost.

 

I was citing my father.  I will be 59 in a week.  My dad died in 1994.  I don’t recall ever, not when he was alive and not since he’s passed, that I ever used a story about my father to motivate anyone to do anything.  Yet here I was, at the LaunchHouse Bootstrap Ball, talking to a couple of high school aged budding entrepreneurs about my father’s greatest asset, how he came alive behind the diamond counter.  And everything I said was 100% true.

Owning a business should never be confused with having a job.  The opportunity to choose what you do, how you do it, and who you do it with are the hallmarks of being the boss, of being in control.  Money?  You might make more money being self-employed or as the owner of the business.  You might not.  Money isn’t the constant.  Risk is.  And with risk comes the possibility of reward.  But reward isn’t necessarily financial.  If you really love what you do and you are able to find happiness in your accomplishments, the money is secondary.  The money is the bonus.  The joy comes from what you do and the money is simply another benefit.

My father didn’t buy into any of that.  He was risk aversive.  He always knew the plot of land or the building he should have purchased.  But Jerry Cunix could sell jewelry.  Watches and necklaces?  No problem.  But diamonds really got his attention.   I had the pleasure of watching him meet with countless couples and individuals as he sat behind the diamond counter practicing his craft.  He served as the manager of jewelry stores in Canton, Akron and Youngstown Ohio.  Never the owner.  The manager.  His stake in his store’s success was limited to being able to retain his job and a miniscule percent of the sales.  He made his employers a lot of money.

Back to the story – my dad so loved the process, the meeting with the diamond salesmen, creating designs, selling the unique and the ordinary, that he created his own signature piece, a tie tack of a hand holding a diamond.

“Mr. Jerry, I’ve never seen anything like that!  Can I buy that from you?”  My dad would hem and haw for a second as he would explain how he designed the piece and had it made up for him, and then would take it off and walk them to the register.  Once the customer left the store, my dad would open the drawer and take out another of his special tie tacks and put it on.  It was all true.  He just forgot to mention that he had a bunch of these made.  Did his employer appreciate his initiative?  Don’t be silly.  But little moments like this gave him great joy.

It is that joy that I wanted to share with these young guys.  I wear my heart on my sleeve.  Everyone knows how much I love doing what I do.  I needed a different example last night.  Not just for them, but for me, too.

It was December 30^th, 11:56 PM.  The client sent me a question via email and had every expectation that I would immediately answer her.  She was wrong.  I had turned off my computer about five minutes earlier.

14 hour days in December?  Crap, I thought that I was a kid again working in retail.  I told a friend that once October hit that I wouldn’t have a full day off the rest of the year.  I’m sure that he thought that I was exaggerating.  I wasn’t.

The last three months have been my industry’s perfect storm.

• Many of my business clients focus on January 1^st.  we review their policies and make any changes, including switching carriers, with the goal of having everything in place for the first of the year.
• The annual Medicare open enrollment is October 15^th to December 7^th.  Many of my senior clients come and visit for coffee and reassurance after the seasonal barrage of TV commercials, junk mail, and the phone calls from insurers and AARP.
• October 1^st was the first day of open enrollment for the Patient Protection and Affordable Care Act (PPACA or Obamacare).

Rules changed daily.  A large part of my time was killed by redoing whatever I had done a week or two before.  Websites crashed like junkers at a demolition derby.  No one really knew what was really right, what was really going to work.

 The only thing I knew for sure was that anyone on television speaking with absolute certainty was undoubtedly wrong.

I have been getting up at 5:20 AM and going to bed around 12:30 AM.  The first thing I noticed, the first casualty, was that my Blackberry was dying in the early evening.  It took a few days to realize that the phone wasn’t the issue.  It wasn’t getting properly charged at night.  Damn, the phone needed more rest than me.

The second casualty was this blog.  I wanted to post.  I tried to write at 11:30 or midnight, but I couldn’t.  I had nothing left in the tank.

I have been writing, just not here.  And I missed you guys and I missed this platform.  Since October 1^st I have posted seven Health Insurance Issues With Dave and emailed seven full-length updates about the PPACA to my health insurance clients.

I love my job and there isn’t anything I’d rather be doing, but it can’t be healthy to live and breathe anything non-stop fourteen plus hours most days.  And when you find yourself in the office on Thanksgiving or knocking out a quick four hour shift on New Year’s, you know that you may be in too deep.

I had to stop and take my temperature.  I needed to know how much of me might have gotten lost along the way.

This blog, which is a large part of me, didn’t get lost, just misplaced.  Jennifer, my daughter, contends that I need to write even if it is only to vent.  I thought about this blog every day.

I replayed in my mind much of the last three months.  Even with all of this work, I found time to visit Jen and her husband Matt; my son Phillip, his wife, Allison, and her parents Bill and Anita; and Sally’s children Alec and Raqui.  I was wherever I needed to be and never rushed through the moment.

A client came by the office last month to tell me that he was dropping his health insurance.  His employer was finally ready to cover him and his family.  I congratulated him and wished him well.  And I meant it.  It is important to me that I didn’t lose my empathy nor my focus through this.

A group of us, agents with over thirty years’ experience, were talking last week.  One compared the last few months to the Medicare Part D (Rx) roll out of 2005.  Others thought this resembled the melt down of 2008-2009.  But the fall of 2013 remind me of the preparations we all endured for Y2K.  The turmoil.  The computer issues.  The gigantic waste of time, energy, and resources.  And we survived.

So I wish all of you a Happy and Healthy New Year.  And if I don’t post quite as often as I have in the past, it is not for lack of interest.  I will be back when I’ve got the time.

The following was posted in July of 2011. Will someone or some community apply this lesson learned from Woody? We will know in a few days…

Woody Hayes once noted, “There are three things that can happen when you pass, and two of them aren’t good.” That little math formula applies to any number activities in our daily lives.

The other day a friend of mine told me that the mayor of his bedroom suburb was running unopposed. That isn’t uncommon in Cuyahoga County. We have 50+ municipalities in our county. We couldn’t possibly have enough qualified people to occupy the nearly countless elected and appointed positions of all of these fiefdoms. Once someone manages to get in, they stay in. Mayors, Councilmen, they either get wheeled out feet first or are led out in handcuffs. This is countywide. Eastside, Westside, South, if the harbor patrol were elected, they would serve for twenty years at a minimum.

So I bring you back to Woody Hayes. There are three reasons why an elected official continuously runs unopposed, and two of them aren’t good.

1. They are truly loved and admired by the community
2. Nobody respects the position enough to want it.
3. Businesses and community leaders have already figured out how to get around the guy holding the job.

The last one is the most interesting. If a politician continuously runs unopposed, he/she has no need to raise a big campaign war chest. This is great for the bottom line. If you as a business can get what you want without having to invest in the politician through the donation/election process, you are ahead of the game and the envy of businesses locked in competitive districts. Nothing beats FREE.

Is there a cost associated with the time and energy a business has to expend to stroke the fragile egos of some local politicians? Sure. But that is negligible, at best. We are ramping up for the election season. Karl Rove’s Super Pac, Crossroads GPS is already running ads on TV. Those cost real money. Hiring a caterer to do an extra ribbon cutting is just an expensive lunch.

So the next time someone brags to you about being unopposed, ask yourself why. Is it #1? Is it #2? Or are you standing next to a walking, talking embodiment of #3?

Today’s title is an elegant sentence written by Martin Amis in his book, Ronnie and the Pacemakers which was excerpted in the November 1988 edition of Esquire Magazine.   Mr. Amis neatly sums up the polarization of American politics in the 1980’s.  Of course, Mr. Reagan had been a polarizing figure for years.   In 1961 he recorded his infamous rant for the American Medical Association attacking the socialized medicine program that would become Medicare.  And Joan Baez and Jeffrey Shurtleff dedicated a song for the Governor of California, “Ronald Ray-guns” at Woodstock.

Having contempt for political figures is nothing new or even uniquely American.  But there must be a line, somewhere, between the disdain or even benign revulsion one may have for members of the political class and the dangerous, barely controllable hatred that was on display this past weekend at the World War II Memorial in Washington D.C.

The speaker was Larry Klayman of Freedom Watch, an organization dedicated to someone’s freedom, just not necessarily yours or mine.  A protest at the World War II Memorial that had been organized by a veterans’ group was hijacked by Senator Ted Cruz, Sarah Palin, and Mr. Klayman.

We are now ruled, quote unquote by a president who bows down to Allah… This president is not a president of we the people.  He is a president of his people.  He is to be the president of all of us…In the course of history there have been many who have used peaceful, non-violence to change history.  I do not advocate violent revolution…I call upon all of you to wage a second American nonviolent revolution, to use civil disobedience, and to demand that this president leave town, to get up, to put the Quran down, to get up off his knees, and to figuratively come up with his hands out.

Forget the fact that the President is a self-proclaimed Christian who took more than a little grief thanks to the Pastor of the church he attended in Chicago.  It isn’t relevant.  When did Muslim become a slur?  Read the above quote or if you can bear it, listen to him spew this rant by clicking on the link.  He bows down to Allah?  Substitute the religion of your choice.  All belief systems other than the speaker’s would neatly fit in that space.  We, Jews, Muslims, Atheists, Buddhists, etc.., are all OTHER.  We aren’t real Americans.  We can’t really lead this country, not Larry’s country.  We’re not white enough.  Not Christian enough. 

I am not Barack Obama’s biggest fan.  Yes, I worked on the 2008 campaign and I voted for him both times.  So What?  It is not like we had any great choices.  But, he, like George Bush before him, is the President of the United States.  And there is a line.  And I’m not sure that I could define that line or tell you where it is.  But much the way Justice Potter Stewart identified pornography, I know it when I see it.  

And if you don’t call it out, if you stand idly by when you hear such talk, then you are complicit in the spread of this hatred.  And you can’t be surprised when someone, uncontrolled by logic and unmoored of reason, takes this to its illogical extreme. 

 

 

My daughter was born in Saint Elizabeth’s Hospital.  St. E’s was the best hospital in Youngstown, Ohio at the time and her mother had had difficulties in the past.  Excellent doctor.  Acceptable facilities.  And on the wall in front of each bed was a wooden cross complete with the depiction of the guy nailed to it.  I found it more than a little disconcerting.  But, it was their building, so we put a towel over the artwork and tried to ignore it.

There are Jewish hospitals, Catholic hospitals, Methodist hospitals, etc…  Are these institutions gifts from a particular faith community for the general good?  Are the hospitals designed as a way to increase cash flow?  Do some religions view the hospitals they create as a way to spread their faith and proselytize for new members?

Hospitals provide needed services for the general public.  The funding may come, in part, from the faith community, but private insurance and the government are the principal sources of revenue.  There are tax breaks, Medicare, and Medicaid.  Does the faith, the name on the door, affect the type of care provided inside?  I am concerned when the religion sponsoring a medical facility chooses to do more than decorate the rooms.

Catholic Health Partners is Ohio’s largest hospital system.  This is a big business.  CHP has two dozen hospitals and over $5 billion in assets.  CHP recently purchased Kaiser Permanente’s Ohio operation.  They also committed $250 million to purchase a minority interest in Akron’s SUMMA Health System.

Everything was proceeding smartly until our local Bishop attempted to kill the deal.  According to published reports, Bishop Lennon stopped the SUMMA deal because “SUMMA publicly stated plans to continue providing sterilization, contraceptives and abortions on a limited basis when medically necessary.” (emphasis mine)

Catholic Health Partners restructured the deal by running it through their auxiliary organization, HealthSpan Partners.  HealthSpan Partners is tax-exempt, secular, and beyond the Bishop’s reach.  I think this raises some real concerns.

What is and isn’t beyond the Bishop’s reach?  What happens when your doctor determines that you NEED a particular procedure, but the Bishop forbids it?

I have a vested interest in this discussion.  The Ohio Kaiser program was lining up to work well with the Patient Protection and Affordable Care Act (PPACA).  The doctors work for the plan.  Kaiser has added new, state-of-the-art facilities.  The patient records system is excellent.  Adding a solid connection to SUMMA is really positive.  I have recommended Kaiser to many of my clients.

But before I recommend Kaiser to anyone else, ever, I need to know who is the final arbiter of what is and isn’t medically necessary.  We are about to enter a long national discussion concerning our government’s involvement with health care funding and care choices.  But for good or bad, we elected the government and we have a role in the creation of our rules and regulations.  I don’t have a say as to who serves as our local Bishop, nor do I care, as long as he doesn’t endanger my clients.

Not paying attention to this would be malpractice.