Tubes in the ears

When Chris, our firstborn, was very young he had recurring ear infections. The treatment for this, once antibiotics are deemed insufficient, is to have tubes inserted in the eardrums to let fluid drain from the inner ear. We had it done, and insurance paid for it all. I seem to recall seeing a bill for one or two thousand dollars, which surprised me since the procedure took about five minutes in an outpatient clinic. This was in the late 1980s.

Last week we had them put tubes in Peter’s ears. This is apparently a fairly common thing for children with Down’s Syndrome. Their ear canals are very narrow, and fluid can build up easily. A hearing test showed that Peter’s inner ears were so filled with fluid that the eardrums were not vibrating properly; he could hear some (we knew that), but supposedly would be unable to make more subtle distinctions between spoken sounds. They tell us that the surgical procedure almost always fixes the problem once and for all. We haven’t seen a bill yet.

Today on Andrew Sullivan’s blog he ran another in his series telling of encounters with the medical system. this one about tubes in the ears [emphasis added]:

This summer my son needed to have tubes put in his ears. These tubes are very small and resemble miniature shoelace eyelets, a design that enables them to stay in place mechanically once inserted. The insertion takes about 10 minutes but requires that the child be anesthetized. For this relatively simple procedure, the surgical center billed us approximately $10,000.

Our insurer cut a reimbursement check to us in the amount of approximately $900. As per verbal instructions from the surgical center, we signed the check over to the surgical center who then adjusted our bill to equal the amount of the reimbursement. Aside from several small co-pays to the ear doctor and anesthesiologist, that adjustment settled our obligation to the surgical center.

While this is admittedly unremarkable, what would have happened if we did not have insurance, or if they did not decide to “adjust” our bill? We were legally on the hook for the full $10,000, a price that was clearly inflated by at least a factor of 10 in the hope that the insurer would pay more.

I am no fan of insurance companies in general, and I do think that reasonable regulation is a good idea, but it does bear mention that doctors and medical facilities are gaming the system too, and gaming it in a way that could easily bankrupt a normal family. How are the proposed health care reforms proposing to remedy what I consider to be bad-faith billing?

This is just one more example of why I have zero interest in the ongoing health care debate. The various parties to the debate are trying to solve the wrong problem. It will not help us in any way to shift the responsibility for paying for health care as long as health care costs continue to spiral upwards into the stratosphere. The problem here is not who will pay the $10,000, the problem is a system that thinks it is right and fair to charge $10,000 for such a procedure.

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“Filthy atrocities”

I ran across this quote recently, from C.S. Lewis in Mere Christianity.

Suppose one reads a story of filthy atrocities in the paper. Then suppose that something turns up suggesting that the story might not be quite true, or not quite so bad as it was made out. Is one’s first feeling, ‘Thank God, even they aren’t quite so bad as that,’ or is it a feeling of disappointment, and even a determination to cling to the first story for the sheer pleasure of thinking your enemies are as bad as possible?

If it is the second then it is, I am afraid, the first step in a process which, if followed to the end, will make us into devils. You see, one is beginning to wish that black was a little blacker. If we give that wish its head, later on we shall wish to see grey as black, and then to see white itself as black. Finally we shall insist on seeing everything—God and our friends and ourselves included—as bad, and not be able to stop doing it: we shall be fixed for ever in a universe of pure hatred.

The phrase “filthy atrocities” caught my eye, because these were often attributed to enemies in the context of World War II propaganda, at a time when Lewis wrote his book and Orwell was writing 1984. And the process which begins where Lewis describes seems to end in Orwell’s Two-Minute Hates and the rest.

Unfortunately, the process also seems to characterize the end point which current political discourse is quickly approaching, particularly among politically engaged Christians. Some are drawing the boundaries of Christian brotherhood ever more narrowly, in order to justify the vilification of those who fall on the other side of line, whether they profess Christ or not; others seem to think that “hate the sin, love the sinner” is excuse enough for going after anyone, regardless of where the line is drawn. Accusations are leveled, and maintained even in the face of unequivocal denials. Rarely have I seen the benefit of the doubt offered, much less heard the sigh of relief that Lewis mentions. More rarely still do I see Christians begin their investigations with the assumption, “Surely this can’t be true.”

Mickey Kaus regularly pokes fun at salacious stories that gain currency in a crowd because they are “too good to check.” Pulling the plug on Grandma? Creeping socialism? Birth certificates? Palling around with terrorists? I think that Christians ought to at least check—and even that is probably setting the bar too low.

Now is the Cool of the Day

A couple of weeks ago Ron Short asked us to learn a song by Jean Ritchie, “Now is the Cool of the Day,” to perform at an awards ceremony in Washington D.C. I found her version on Rhapsody, we worked it up quickly, and we liked the result. Really liked the result. It will probably be the title song for our next secular CD, if that ever comes together.

After we performed it in D.C. some of the folks there asked us which of our CDs it was on. I told them that we hadn’t recorded it yet, but that we would be glad to send them a demo. Chris and I recorded it this afternoon on the porch, and here it is. Sorry for the occasional rattling sound; I don’t know what caused it.

Jean Ritchie songs are often an unusual experience for us. When we first heard her versions of “The L&N Doesn’t Stop Here Anymore” and “Blue Diamond Mines,” they sounded good but not like anything we’d ever do. But when we heard Robin and Linda Williams do their own arrangement of “Blue Diamond Mines,” we were knocked over and quickly added it to our repertoire. And when we started doing “L&N” it changed underneath us, not sounding so much like Ritchie’s version anymore but very much like us, and one of our favorites.

Same with “Now is the Cool of the Day.” Based on Ritchie’s version, I wouldn’t have picked it for us. But as we played through it a few times it molded itself to our own style, and now it is already a very special part of our repertoire. I’ve changed the melody slightly in a few places, something I am normally very reluctant to do, but there were reasons for each change and I think the end result is very much us.

The song doesn’t show up very much either in Rhapsody or on YouTube, but if you’re curious the few versions on YouTube will show you how different the song becomes in different singer’s hands.

Leisure, Chapter 5

I did not understand much of what Joseph Pieper was saying in this final chapter. Part of the reason, I think, is that I don’t share enough of his assumptions to understand his points readily, and I’m not interested in learning enough about his assumptions to do that.

I do have one last thing to say in response to the overall reading, based on what I think is a wrongheaded distinction between work and leisure. But I don’t have time to write it up right now, and it wouldn’t hurt me to spend a few more days thinking it through.

Christian standards for engaging the culture

I follow Doug Wilson’s Blog and Mablog because I think he is a trailblazer for an approach to Christian cultural engagement that is always aggressive and often belligerent—laughter is war, as he says. I don’t understand this approach well enough to dismiss it, so I keep reading, sometimes with gritted teeth, in the hope that I will eventually come to see how Wilson and his followers justify what looks to me like gleeful mockery—of brothers as well as the world—generously larded with the kind of jesting (what Strong’s translates as “scurrilous, ribald, low jesting”) that Ephesians 5:4 exhorts Christians to avoid.

In a recent post, Cheering for the Cowpie Channel, Wilson begins as follows:

I have said before that I find Sean Hannity barely tolerable. Whenever I see him, which is rarely, Bill O’Reilly provides an ongoing trial of the purity of my sanctification. And I have only seen Glenn Beck for a few minutes in YouTube clips, but that man is clearly a histrionic specimen of the first order.

I take all that as meaning that he does not like how they do what they do. But does he like the thing that they do? In some fashion, yes. Wilson continues:

That said, and fully acknowledged at the front end, I take great pleasure in the fact that, for the first time in my adult life, we are seeing an old-fashioned political brawl, the kind that suit-and-tie Republicans could and would never initiate.

I take that as meaning that Wilson likes old-fashioned political brawling itself, just not the fact that Hannity and O’Reilly and Beck are the ones who are conducting the Republican side of it. Why not?

These cable channel men, clearly not qualified to do so, have taken up a noble task that the certified gentry of conservatism would not touch with a barge pole.

OK, so the task itself is noble, the problem is that the men who have undertaken it are not qualified to do it, while the ones who are qualified to do it have become so gentrified that they won’t dirty their hands with the task.

Of course the Obama White House is chockablock with commies. It is beyond delightful to find people willing to say so, with an audience of millions, and who lack the sophistication to know that what they are doing is just not done.

It’s not important to my point here whether or not the White House is chockablock with commies, only that Wilson thinks so. And so he is delighted that someone has had the courage to say it. I’m not sure whether it’s the audience of millions that he thinks are unsophisticated, or Hannity and O’Reilly and Beck. Perhaps both. In any case, he seems to be willing to pay the price of having unqualified, unsophisticated messengers as long as the message gets delivered.

So apparently the importance of getting the brawl underway trumps the fact that it is being instigated and pursued by people whose behavior Wilson can barely tolerate and who he thinks are unqualified to engage the other side—which I guess means that for the wrong reasons they are accidentally saying the right things, such as claiming that the White House is chockablock with commies.

But what justifies this? Aren’t Christians supposed to let their yes be yes, and their no be no, regardless of what we think the outcome should be? Is this some sort of theory of co-belligerence, where we can encourage others to engage in behavior that is distasteful and untruthful as long as the outcome is desirable and our own hands stay clean?

Wlison ends his post with a helpful analogy:

It is as though an uptown lady bought a Mao T-shirt for 500 clams at an upscale boutique somewhere, and some cornpone fresh off the farm threw a cow pie at her for doing it. Sharp intake of breath all around, right? But in the cosmic scale of values, which is more of a moral blunder? Throwing a cowpie at a clueless rich lady, or wearing a T-shirt celebrating the sociopath who murdered scores of millions of people? [Emphasis added]

So, the key to managing such situations is a keen sense of the cosmic scale of moral blunders. As long as an action taken is less of a moral blunder than the action it is responding to, it is justifiable. Or, if I read Wilson’s final sentence correctly, it is at least an action that Christians can encourage others to take, if not take for themselves:

Anyway, that’s what it is like. So set me down as cheering for the cowpie channel.

I should say at this point that I don’t mean this to be some sort of “gotcha” analysis of Wilson’s post. I mean it to be a plain reading of the post by someone who doesn’t agree at all with Wilson’s approach to engaging the culture, and who is trying to understand in more detail the source of the disagreement. I don’t doubt that Wilson and his defenders will find his thinking in this post consistent with his overall view of the Christian life. What I want to know is whether my own view, which seems to me to rule out Wilson’s approach, is somehow wrong or deficient. I’m hoping that such close reading of Wilson’s writings will eventually tell me that.

Don’t Look Now

I loaded a bunch of albums from early in my music listening history onto my MP3 player, and as I drive here or there I listen to some of it. This morning after dropping Maggie off at a crafts event an hour away, I used the ride home to listen through some old Creedence Clearwater Revival tunes.

Before steeping myself in bluegrass and old-time music I never used to pay much attention to song lyrics; now I think of them as the heart of a song, and I pay close attention. John Fogerty wrote some great songs, and occasionally the lyric itself was great. I was surprised and pleased as for the first time I paid attention to the words of “Don’t Look Now,” which Buck Owens or Merle Haggard could have done without shame:

Who’ll take the coal from the mine
Who’ll take the salt from the earth
Who’ll take a leaf and grow it to a tree
Don’t look now, it ain’t you or me

Who’ll work the field with his hands
Who’ll put his back to the plow
Who’ll take the mountain and give it to the sea
Don’t look now, it ain’t you or me

     Don’t look now, someone’s done your starving
     Don’t look now, someone’s done your praying too

Who’ll make the shoes for your feet
Who’ll make the clothes that you wear
Who’ll take the promise that you don’t have to keep
Don’t look now, it ain’t you or me

      Don’t look now, someone’s done your starving
     Don’t look now, someone’s done your praying too

Who’ll take the coal from the mines
Who’ll take the salt from the earth
Who’ll take the promise that you don’t have to keep
Don’t look now, it ain’t you or me

Leisure, Chapter 4

As I wrote earlier, I am having difficulty engaging Pieper’s thesis directly because I think we disagree on how to divide up the problem, and I don’t really have the time or interest to map out our differences in enough detail to go on and tackle his arguments. Worse, I’m not all that opposed to the practical outworkings of his conclusions, as far as I understand them; the only world where our differences would have implications for real life is a very, very different world than the one we live in today.

But I still have some gripes with his assumptions. And I was not surprised to see him quote the Pope Pius XI encyclical Quadragesimo Anno, because I recall my disappointment at having exactly the same gripes when I read through that a few months back. At heart, I think that the modern Catholic stance on the problem of labor, though enlightened and a valuable counterbalance to the capitalist ideal of all-encompassing work, boils down to a position of accommodation, one which grants that wage slavery is OK (or at least inevitable)and then tries to make conditions for the slaves as humane as possible, e.g. the work stays the same but the wage becomes a living wage.

Pieper takes roughly the same position with his idea of de-proletarianizing life, wanting to open up a bit of space for leisure in a life that is otherwise totally oriented towards work. And I have to suspect that this thinking is connected to his Thomist devotion to Aristotle and Plato, for whom the freedom of a free man depended critically on the existence of slaves to do what things are necessary to supply his needs. Pieper is apparently willing to admit that slaves could benefit from a bit of leisure, but not consider the possibility that it is wrong to divorce the servile and liberal arts—and then burden slaves with the first so that the free can wallow in the second. As Wendell Berry has repeatedly pointed out, man has an uncanny ability to take a happy solution and split it into two miserable problems. And I wonder if this ancient distinction between liberal and servile isn’t exactly that.

At one point Pieper touches on something that I think may have given rise to this illegitimate distinction, what Marxists call alienation of labor, the idea that a worker’s effort can be recast as a commodity, as something that can be bought and sold (and, consequently, wrested from his control). In a completely self-sufficient household, it is nearly impossible to put a price on individual acts of labor, or even to associate such acts with a product—what is the cash value of a morning’s worth of weeding, or a week of canning, or catching and killing a rooster for Sunday dinner?

And in such a context, the concept of enough becomes a concrete reality—what is the use of weeding when the weeds are under control, or canning more food than you can eat during a winter, or catching more chickens than will be eaten on Sunday? Leisure is then the time that becomes available once the work’s all done, once the needs of your family are seen to. In an agrarian culture this point comes as God sees fit, depending not only on the diligence of family members but on circumstances, the weather and the harvest and unplanned events and so on—but it does come. In the world of total work, it never comes for the worker. In Aristotle’s world, it never came for the slave, and came unearned for the free man.

I am not at all suggesting that the solution to Pieper’s problem is to abandon modern life and replace it with life as it was lived in this country in 1800. If doing so were possible I think it would solve the problem, but it is hardly possible to do as a society. So although I am skeptical of Pieper’s idea of de-proletarianizing life, it is not because I think it won’t work, but only that I think we have no reason to assume it will work—because Pieper (and Catholic social thinkers in general) have wrongly analyzed the problem. Adding in a bit of leisure may improve the lot of the modern-day wage slave. But it will at best produce a more balanced, more palatable slavery, and not tackle the problem at its source.

The good news, though, is that I think the problem can be addressed at the level of the individual family, to the extent that such families are able to abandon modern life and replace it with self-sufficient living. And this need not be a move to the homestead. I think that what the agrarian thought experiment above tells us is that the critical concept which has been lost is the idea of enough. To the extent that we can arrange our lives so that in various areas we reach a point of enough—enough schoolwork, enough hours at the office, enough friends, enough social obligations, enough enrichment activities for the kids, enough passive entertainment, enough sports, enough time spent on the internet—then leisure will naturally introduce itself.

The trick then, I suppose, is to figure out what to do with it.