Curmudgeon's Corner

I am the patient of an Advanced Healthcare doctor. My first reaction to the early news that Advanced Healthcare and Aurora were negotiating a joint relationship was one of wait and see.

Now, some weeks later, there is the outward indication of a significant change in relationship…a formal announcement by the two parties has been issued.

My initial reaction to the announcement over the week-end that this likelihood seemed nearly a fait accompli was one of concern. I was concerned for me as a patient, for my doctor as a participant, for Community Memorial Hospital as a threatened institution and for the whole healthcare topography in S.E. Wisconsin.

I had an unexpected opportunity over the week-end to experience healthcare first-hand. As the result, I also had the opportunity to talk with a couple of physicians…one a member of Advanced Healthcare and the other a member of another group [but who would be impacted by any issues ultimately surrounding the viability of Community Memorial]. I also had the opportunity to interact with employees of Community Memorial Hospital, although I chose to not engage any of them in this discussion.

The Advanced Healthcare doctor told me that he had mixed emotions as did many of his peers. He also stated an interesting statistic as follows: a handful of years ago, Advanced Healthcare was one of a couple of hundred similarly-sized group practices in the U.S. but today it is the sole group practice of its size left in the U.S. Each of the others has been acquired, has merged or has somehow been absorbed by another entity. He reminded me that even though each physician sees his patients as a sacred trust, the corporate folks understand that healthcare is a business. And businesses must remain competitive in order to survive. If one group of physicians lost its edge, many of its patients would quickly migrate to another practice that had the edge. We patients expect our physicians to be “loyal” to us, but we can move without those same feelings flowing in the other direction.

The non-Advanced Healthcare doctor told me that there were mixed emotions of a very strong nature inside and outside the systems involved. He said little else, I presume because of the highly-charged situation of which he is a part.

I saw no sign that staff members had changed in any way as the result of this news. Some probably had no idea that such news had been issued while others felt they would be okay no matter what. It is, after all, difficult to imagine that a hospital of the size and reputation of Community Memorial with its partnering relationship with Froedtert could not survive very ably in almost any situation.

Maybe the other suitor earlier reported will step up to the plate with an offer to Advanced Healthcare that transcends the deal in the current discussion. If so, it could be that my concerns would be for naught; or it could be that I’ll have a whole new set of concerns.

If we simply take a look around us, we’ll see that there has been consolidation of insurers and consolidation of hospital groups. If the physician groups do not scale up in size, they will have lost much of their negotiating leverage with both the insurers and the hospitals. We cannot foretell what such consolidation will mean to the cost of healthcare; it is easy, however, to postulate increased costs given fewer alternatives and more buildings and more expensive equipment and less competition [in the form of fewer competing entities].

Physicians generate the bulk of patient flow for hospitals by their admitting profiles. So these physicians have significant leverage at the moment.

Could our local hospital emerge strong as ever? Certainly it could.

Could it emerge as a weaker entity? Certainly it could.

Could it simply go away as we know it today? If Aurora were to acquire or merge with Advanced Healthcare and then build a northern tier hospital as has been discussed; and, if Medical Associates were to conclude negotiations with ProHealth located in Waukesha and began referring patients in that direction…certainly it could.

Whatever your thoughts, this is an exciting and/or troubling time for we consumers of healthcare in this area.

Our first home in Germantown was on the corner of County Line Road and Mayflower Drive. We lived there for 19 years. Our kids did most of their growing up while there. Now, it has changed…and in the blink of an eye…or so it seems.

The small house to the west of where we lived doesn’t exist anymore. Now, it is only an empty space covered in straw. Same for the house on the next corner and the house next to it.

Those houses were razed as part of the County Line Road improvement project. Improvement is often in the eye of the beholder. I know that there is much more traffic today than there was in the span from 1969 through 1988. But, there were some great old trees that have bitten the dust. There were homes that served many families well, and those have been torn down.

All this in the name of progress, of course. If we hadn’t lived there for so long, it is very unlikely that I would’ve felt the way I do. I would’ve passed by barely even seeing that something had changed…and not quite being able to put my finger on that something.

I think about these things when I course through the back country roads past old, dilapidated barns and farm homes. I wonder about the people who lived there…and died there in many cases. What were their names? Did they raise large families? Have the children returned to stare at the emptiness? Do they have a tear in their eye when they realize that their youth is gone…or at least the vestiges of their youth?

Do we take the time we should to reflect and to remember? I try, but I know that I get caught up in the day-to-day and I don’t take the time I should. There are occasions such as now when I reminisce…but those times are too few and too far between I fear.

There will come a time when I can no longer remember the faces of those neighbors, no matter how hard I try. There may come a time when I’ll not even remember that I lived there. I hope that there are those who will pause on their way past to wonder if we raised a family there and what we did for a living, and pondered at the passing of time and memories as I do today.

Everything comes full circle…or so it seems. I feel sorry for those who are unable to take the time to pause to remember. I feel even sorrier for those who know they should and refuse to be drawn in to that maudlin process we call remembering.

I hope you weren’t too happy when I said I have to go to The Jailhouse, for I was talking about going to my new favorite place to dine. You’ll find it at the corner of CountryAire and Pleasant Valley Rd. and I think it has a West Bend address. The phone number is 262-675-9302.

Those who know me know that I love to eat. I love to find out-of-the-way restaurants that have all the right things going for them. My failing is that I love to tell people about my finds. I should just keep these great places to myself, but, instead I blab about them and then get crowded out by the very people who learned of the place because of my big mouth!

The proprietor (a nice young lady who really has her head in the game) recognizes her repeat customers very quickly. If that sounds like something from the past that you just don’t find anymore, it sure seems that way to me, too. You’ll feel welcome in almost any attire. My blue jeans get a real work-out here.

But, back to the food…I love the Jailhouse menu. And, I love the Jailhouse food. Crisp garden salads, great homemade soups, a very well balanced menu of poultry, seafood and meat, a nice selection of homemade desserts…and a wait staff that does it right…period! Oh, and if you like a cocktail, you’ll find they have a really good bartender, too.

The long and the short of it is this: the Jailhouse does it right. We’ve been very impressed. Friday nights get crowded after 6:00PM but there is no wasted motion so the crowd moves through pretty quickly. The “Fish Fry” selection includes some of the best Walleye I’ve had along with all the customary items. And, if you like French fries, try their home cut French fries.

All this, and the prices are reasonable…not high and not low…reasonable. They give good value in a very pleasant atmosphere

Take Hwy 45 to Pleasant Valley Road (where the Washington County fairgrounds are to be found), and then East on Pleasant Valley until finally you arrive at a relatively small and very old building at the corner of CountryAire and Pleasant Valley. The Jailhouse is closed on Sunday and Monday.

I think you’ll share my feelings for this great little place with a big heart. And, like Cheers, you’ll get to be recognized after just a few visits. If you don’t like it, e-mail me but don’t expect me to pick up your tab!

Most of us watched at least part of the coverage of the single most devastating killing spree in America’s history. I was nearly speechless except for being angry with a system that had permitted this killer to pass through several “checkpoints” where he should’ve been identified and dealt with long before his death march across the VT campus.

This was an angry young man that showed his discontent many times. If only those around him would’ve but taken the time to notice and to let someone in authority know of their concerns. If only in those few times when that occurred, had those in authority responded appropriately.

This was an angry young man that knew he would be the sole possessor of guns that fateful morning on campus. He knew that the campus was a “no gun” zone in a state that had approved the conceal and carry law some years earlier. This angry young man knew that even the campus police were not permitted to carry firearms. He had it just the way he wanted it…a killing zone all to him self! He was so emboldened as to take a break from killing to mail a tape and other items to NBC before he again turned to killing the others.

This was an angry young man who despised those around him. He refused to speak for days at a time. He lived in a dormitory where his room mate said that it was not uncommon for no words to be exchanged for days or even weeks. This was a young man for whom things weren’t right.

This was an angry young man who obeyed the law when he went to purchase his guns. Even though he had been declared a danger to himself and others following a psychiatric examination a couple of years earlier, no one had wanted to file the report so as to prevent damage to the young man’s reputation. Had that been filed, the mandatory record check by the gun store owner would’ve shown this angry young man was not fit to purchase a pistol…let alone two pistols a short few weeks before the fateful day in the killing zone.

As it was, the cameras found the gun store dealer who violated no laws and pilloried him instead of the system that had fallen down months and years before.

This was an angry young man who skated through politically correct academia for a seemingly endless time demonstrating again and again that he didn’t belong in this institution of higher learning…and yet his “rights” were protected…to a fault!

And…what of the rights of the thirty-two innocents? Who was so concerned about their rights to draw another breath, or to see another sunrise, or to enjoy another kiss, that they thought to protect society from a killer-to-be who tried desperately to expose himself, but all for naught. No one paid him any mind; everyone who thought him strange, chalked it up to their imagination, or told themselves it wasn’t their business, or any number of other things to excuse their turning their backs.

Now the anti-gun folks are out lamenting that firearms are so readily available. Yet, what if the campus had not been a gun free zone in the middle of a “conceal and carry” state? Would someone who was carrying a concealed weapon lawfully have taken note and interceded? We’ll never know will we? But I submit to you, the outcome certainly couldn’t have been any worse now, could it?

Would a seventy-three year old holocaust survivor and professor not have had to barricade the door to his classroom with his body so his young student wards could flee through the windows to their safety while he died for them?

Would moms and dads have been able to welcome sons and daughters home this week-end instead of attending the funeral of a child lost to craziness?

When, if ever, will we learn the high price of political correctness? When our liberties are fully eroded…or just before when it is too late to correct the failures of the years before? The years before when we could’ve stood for the things that, at one time anyway, made this country great?

I am greatly saddened on many counts, far more than the thirty-two counts of negligent homicide of which we citizens who did nothing are guilty!

This is the anniversary of Jackie Robinson’s first game in the “big leagues” as a Brooklyn Dodger.

I was five years old and living with my mom and dad in a small town in western Wisconsin. I was a Dodgers fan from the first recollection I have of liking a baseball team. I don’t know when or why the Dodgers became my favorite team. Maybe there was much “to do” about Jackie Robinson. I heard the Dodger name enough to think they were very special.

And special they were, given that this was the first major league team to break the vaunted color barrier, as it was called then. I read this morning that Bud Selig views this date and that moment as the greatest in baseball history. Bud has his fans and his enemies, but he is a real student and historian of baseball.

As kids in Viroqua, we had no clue as to the importance of a Jackie Robinson from the perspective of race. None of us knew there were differences then. I just loved my Dodgers and names like Robinson, Campanella and Reese. They were my guys and I didn’t know there were differences.

Reflecting back, after living many more years and having had many more life experiences, I never really gave any thought to a color barrier. Even though I grew up in a community that knew when the “gypsies” were close to town, or when the “carnies” came along with the County fair.

During basic training at Ft. Knox, there were nine of us from the same small town thrown together with another 200 or more strangers with our hair shaved off. Our Saturday afternoons were often spent wrestling with a group of Texans between our two barracks. I don’t recall thinking about race, but I sure wasn’t fond of those darned cowboys.

As a National Guardsman on the streets of Milwaukee during our riots, I was concerned for the troops under my command, but I honestly don’t recall harboring any thoughts about race; there were bad guys and good guys; no races. Maybe we were all too scared to think about anything but getting through the experience.

So, I reflect on Jackie Robinson and it reminds me of the “good old days”. They really were good old days; filled with summer and winter fun, teachers throwing erasers to wake sleeping students, writing repentance on the blackboard with chalk after school, and an English teacher that I nicknamed the “purple eagle” for her fierce stare and color-rinsed hair.

Jackie Robinson was simply one of my favorite Dodgers!

The snow and sleet and rain and whatever else has fallen on us today serves as a reminder…we are not in control!

This is not supposed to happen at this time of year, and yet it does. And, we survive.

What does this tell us, if anything?

It tells me that I have not the ability to comprehend the wonders of the world in and on which we live.

It tells me that I should be suspect of those who would have me believe that they do have such ability.

It tells me that this world of which I’m a small part was created and didn’t just happen in some cosmic explosion or implosion.

It tells me that all the hand-wringing over global warming is for naught since no amount of hand-wringing by mere humans is going to have any impact…pro or con…on this issue…if it is truly an issue.

It tells me that I need to watch over nature as best I’m able while I live life. It tells me that creatures great and small have the right and the ability to exist with one and other.

I see nesting eagles in Mequon when only some few score of years ago, we thought it possible that we had caused the ultimate destruction of the bald eagle.

I see a state almost overrun by turkeys…the wild kind, not the human kind…and I am reminded that we began the repopulation of wild turkeys only a short two or so decades ago.

It tells me that the creator of this earth upon which we all live, was and is infinitely more knowledgeable, caring and compassionate than any or all of us in combination.

It tells me that I will continue down the path I’ve chosen to tread; while I let those who desire to tread different paths tend to their business as they see it. Only if they choose to try to alter my selection will I pay any attention to them and their choices; and, then I’ll let them know that I couldn’t care less what they’ve decided for I am at peace with my selections and my decisions.

Therein may lie the definition of a curmudgeon; certainly it is the definition of a crusty old, independent, self-assured male.

Ain’t nothin’ wrong with that so far as I see it.

Once upon a time, Wisconsin was a decent place for new businesses and existing businesses. Taxes were such as to permit new businesses to gain a foothold and to permit existing businesses to fund growth while covering the tax obligation to state and local governments.

We have evolved under both republican and democrat leadership to the point where we rank 7th of all 50 states in combined property and income tax load in 2006. We have been in this general area of ranking for the past several years.

Now, however, we citizens of Wisconsin are being attacked on many other fronts with both tax and fee increases. Beyond these attacks are more that threaten to remove our rights in addition to applying penalties for certain habits deemed to be less than appropriate by others.

I am particularly concerned today with a set of such tax and rights actions.

Cigarette smokers are a particularly “juicy” target. They are about 23% to 25% of the state’s population; that number has been constant over several years. Cigarette smokers are not organized and, therefore my mention of them as a "juicy” target. Anyone can take shots at this group for days, weeks and months on end and draw nary a peep in response. This group faces an increase of $1.25 per package of cigarettes raising the total state tax to $2.02. That represents an increase of 125% from the current $0.77 per package.

The taxes gathered are supposedly going to be used solely for health care purposes and education to keep future generations from smoking. I remember that same argument being used when we were a “Johnny-come lately” joining umpteen other states a few weeks before the smoking money decision was rendered. I doubt that any more than 1% of that money went toward educating kids on the evils of smoking. The rest found its way into other pet projects of our Wisconsin politicians.

Can we therefore cynically expect a similar outcome from this effort? I suspect we all know the answer to that question.

There is another piece to this tax increase that has seen little press. It refers to the increase from about 25% to something in the range of 65% tax on the wholesale cost of “Other Tobacco Products” or OTP. Those products are largely made up of premium cigars. That represents an increase of some 38% in the tax rate. If a cigar had a wholesale cost of $4.00, it has a current tax of $1.00 added thus making the fully loaded wholesale cost $5.00. That amount is marked up by the retailer to covers costs and to make a profit. That same cigar, in the new world desired by the tax increase crowd, would have new fully loaded wholesale cost of $6.60 before the mark-up is applied.

This OTP group of premium tobacco products accounts for about 5% of the total of $291 Million dollars collected, or about $14.5 Million.

The tax increase for cigarette smokers is a foregone conclusion. I cannot argue that since I believe cigarette smokers do suffer higher health care costs. IF, and that is a big IF, the increased collection of taxes was truly dedicated in large part to the health care needs of those smokers, I would be very comfortable. As my cynical self mentioned earlier, however, I don’t for a minute believe the money will go there.

I am convinced however, that an increase in the OTP (premium tobacco) tax is purely vindictive, amounts to little more than a “hill of beans”, and is not justifiable based on the “increased cost of health care” argument.

Let me further expand upon the “vindictive” theme. Other legislation is pending today that would forbid smoking anything in any public establishment in Wisconsin.

That includes cigar shops such as my favorite, Metro Cigars in Germantown, WI. It has nothing whatsoever to do with innocent people suffering the harms of “second-hand” smoke. This is purely the knee-jerk reaction of the do-gooders who think that I should not be permitted to enjoy my chosen lifestyle even though it harms no one other than possibly me and the employees of Metro Cigars…who have all chosen to be there. Don’t engage in the, “well the employees had no choice; they had to have a job” argument. That is pure bunk. I know the employees of Metro Cigar and anyone of them could easily have another job if they chose.

I encourage you to make your views known to your elected representatives. The tax increase proposition is part of the state’s budget, so it will not have a separate hearing as would’ve been the case with a free-standing bill. By pasting this to your browser address bar http://waml.legis.state.wi.us you will be able to locate your state legislators so that you can make your voice heard. And please do so today because there is not much time left before positions harden. The budget battle is likely to continue on through the summer, but don’t count on that and miss your opportunity.

Maybe it is just me, but I find the whole Georgia Thompson story troubling. We have a jury of twelve peers convicting her on the charges brought that she manipulated the outcome of the Adelman Travel contract debate. We have the appellate court in Chicago hearing and tossing the result in a matter of a few days with her release from prison ordered almost immediately. We have righteous indignation from the Doyle camp, that earlier disavowed anything to do with the lady or even acknowledging it knew who she was, including the invocation of the name “Karl Rove” by a democratic assemblyman.

Something simply doesn’t smell right about all this, but I can’t put my finger on what it is other than maybe “politics as usual”?

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The Supreme Court has just ruled that the breath we exhale is dangerous and must be regulated by the Environmental Protection Agency. The United Nations has just issued another alarming finding on global warming calling to mind deserts, flooding and all manner of bad things, while a body of similarly situated and well-meaning scientists postulates that we are nowhere near a calamity as is being depicted. One group calls for the “greening” of America while another points to the “fact” that China and India are doing more damage than can ever be righted by all the rest of the world’s countries combined. One thing seems certain to me: we don’t really know whether this is bunk or the foretelling of our future.

How do we, the common folk not given the ability to discern things so far beyond our mental capabilities, learn the truth? I don’t know. I’m not sure there is a “truth” given the lack of long-term record-keeping, the relatively short time man has been on this earth, and especially given the huge amounts of money at stake on all sides of this “issue”. I doubt that I’ll find the “truth” in a slide show or the UN or the halls of congress. I do know that huge economic consequences ride on the coattails of the issue. I feel that the efforts to date have largely focused on how terrible is the United States, much of that having been generated by political forces within our country. I feel that few of the good-hearted people in this movement realize just how they’re being manipulated and used for other ends. Again, is this just “politics as usual”?

* * * * *
The associations of health insurance professionals of which I am a member (Wisconsin Association of Health Underwriters and the National Association of Health Underwriters) have recently made available a great interactive tool. By clicking here you will reach the website of the Foundation for Health Coverage Education. Follow the simple instructions by selecting your state, and answering the questions and you will see which programs in Wisconsin or elsewhere will provide answers to your needs for health care coverage. All the information you provide is held in confidence and is used solely to provide you with the information about how to obtain health care coverage.

The Foundation for Health Coverage Education was formed by a health insurance agent who lives and works in California. He saw the need for this kind of information and used his money (earned through his career as an insurance professional) to create the foundation and steer it toward providing services such as this. He has been joined in this effort by the associations and their members mentioned earlier, and together we are all helping to make a difference.

Please pass this along to those you know who can use some help with their health care needs.

Thanks to each and every voter who went to the polls yesterday to register their position on each ballot question. It has been reported that turn-out was in the range of 30% which is great for a spring election.

Also, my thanks to Charlie Hargan for many years of faithful service to Germantown. The voters were apparently ready for a change and voted that way. I hope that Tom Kempinski will govern with a steady hand in the interests of all Germantown citizens as I suspect he will. I haven’t seen Mr. Kempinski hoist a mug yet for MaiFest, but suspect he’ll be up to the task! Charlie always appeared very comfortable in that role!

I hope that the trustees, who openly supported Tom Kempinski, will not roll over and abdicate their individual responsibilities of properly analyzing each and every motion he may favor before simply applying “rubber stamp” approval.

We can all be thankful that the race for Supreme Court justice is over. I made no bones about my choice, so I am happy too with the outcome. I am very thankful that this race is behind us; it was the most singularly disgusting political race I have witnessed…including the most recent race for governor. I sincerely hope the outcome may help those who believe in mud-slinging to understand that we voters do sometimes have the ability to work our way through the real issues to make decisions. I doubt that it will have that desired effect, however; the mud-slingers seem unable to help themselves.

I was disturbed that our new justice was lax in a couple of instances, such as the hearings and dispositions involving the bank for whom her husband serves as a director. I trust she has learned a valuable lesson and note that their family investments are being moved into a blind trust to remove them from suspicion going forward.

I was disturbed that the opposition candidate permitted out-of-state dirty tricks people to be brought into Wisconsin to conjure up more dirt to be used to make some of the mud; and then denied that they had misrepresented themselves to a Washington County deputy. The deputy, a sworn officer, was there and the candidate was not.

It seems that local police officials are going to need to prevail in hearings or find a way to get along with the Mid-Moraine Municipal Court judge since he won re-election by something less than 400 votes.

Finally, I am happy that we taxpayers found the strength to stand up and say “No” to the referendum question concerning payment to assure development doesn’t occur. And, we did so in resounding fashion. Maybe that one will not find its way back for some time.

Darby was only ten years old but it was apparently that time when she was needed elsewhere for more important things. As is always the case, no one was really able to understand her too early departure. Those who knew and loved her were simply left to ponder the imponderable and what it means to each of us in our individual private thoughts.

She left behind a sibling, Roxy, and a grieving family. She also left behind a cadre of friends, self included.

Darby had, until very recently, led a carefree life with the loving family of which she had the good fortune to be part. She lived in the country and was free to enjoy the beautiful out-of-doors. She and Roxy quarreled from time to time, but who hasn’t quarreled with a sibling? Her Mom and Dad had to correct her once in awhile, but who’s Mom or Dad hasn’t had to do that with us? Darby’s Grandpa and Grandma were very close to her, as well. Truth be told, they spoiled her a bit now and then, but that was bound to happen when Darby looked at you with her beautiful dark eyes.

She was a wonderful friend. She didn’t expect much more than a casual word or two, and maybe a little back-rub. She made it a point to say “Hi” to all her friends whenever she walked into a room. She wasn’t boisterous except for those rare occasions when Roxy caused her to be a little louder than she liked when forced to defend her turf. Oh, and she loved having her rump scratched!

As you may’ve already determined, Darby was a four-legged person. She was a beautiful, sleek-coated 10 year-old Black Labrador who should’ve had another five to seven years with her loving family and friends. But…that wasn’t to be. So now we reflect and try to comfort her immediate family while we all keep those “stiff upper lips”.

And someplace there may just be a new brother or sister for Roxy (the cutest English Bulldog you could ever want to see).