In the Senate and the House, rousing debate is now going on (or will be again when they return) on various aspects of bringing health care insurance into the 21st Century. One bitter difference involves bringing down costs. Democrats claim that substantial cost savings can be realized by nationalizing medical records so as to minimize duplicating tests and treatments. They also believe that ways can be found to reduce hospital administrative costs. I agree.

       As an 87 year old senior citizen who visits many  Doctors’ offices and periodically undergoes hospital medical  procedures, I have personally witnessed some damnably wasteful practices. For the most part, these are it’ty-bit’ty mistakes, but I am a single individual. Multiply the waste in time and labor of each error I experience, and multiply that by millions of hospital visits, and you will say, “Huge sums of public money are being frittered away.”

       Whenever I visit a Doctor for the first time, I am given several sheets to fill out. They need my name, address, telephone number and  e-mail address. They also need my age, date of birth, height, weight, Social Security number, supplementary insurance policy number, the name and address of the supplementary insurer, the name and phone number of my General Practitioner and an emergency contact name and phone number. There’s more. Have I ever had cancer, a heart attack, diabetes, a stroke, major surgery, etc.?  I need to list the medications I am taking , strength and frequency of use. I’m sure there’s more, but I can’t remember it all.

       Since I recognize the need for this information, I do not begrudge the Doctor the 30 minutes to fill out these forms.  I deeply resent  that, when I visit another  Doctor the following week, I must spend another half-hour filling out essentially the same forms.A waste of time but, since it is my time, there is no financial cost to doctors, Medicare and insurance companies. Fortunately , when I again visit  the same Doctor, he doesn’t  require that I duplicate my clerical efforts.

       Not true when I register in a hospital. I have recently visited St.Vincent Catholic Medical Center  in New York at least eight or ten times for medical procedures. The forms I am asked to fill are similar to those in  Doctors’ offices, but with one major difference. Each time I am admitted to St. Vincent, they require that I  fill out the same form. Complaining to the Nurse avails me nothing. “We are only following procedure.” I point out that this is costing the Hospital extra money in paper, ink and the Nurse’s time. At the Hospital,  it is not just my wasted time; there is a continuing extra cost to the Hospital. It is an it’ty- bit’ty expenditure, but multiply that by the very large number of patients they service, and the it’ty-bit’ties pile up. Multiply that  total by the number of hospitals in the Country using similar wasteful procedures,  and you have a significant sum.

       It gets worse. I am a member of Medicare, I also carry a supplementary policy covering pretty much everything that Medicare fails to cover. When I sign in at St.Vincent, I write down both my Medicare number and the supplementary insurance company’s name, address , phone number and my policy number.  Invariably, a couple of weeks later, I get a Hospital bill advising me that Medicare has paid a certain amount and that I still owe them the balance –– a balance which my supplementary policy insurance always covers.  

       I then phone the Hospital billing office and explain the situation.  The clerk takes time to look up my record, takes time to write down my supplementary policy information, checks to see that all is O.K. and then takes time to correct the record.  A waste of time and money. Estimate a loss of  30 minutes at at least $10.00 per hour. This does not include the cost of. sending me the bill and, if I don’t phone back quickly, the cost of sending a duplicate bill. Another waste of at least $10.00. Money unnecessarily thrown out. Again, multiply this $20.00 cost by the number of patient in the same situation and multiply again by the number of hospitals with similar slipshod practices. 

       These are just small unnecessary costs with which I personally am familiar. I suspect that these are the tip of the iceberg, and that many other examples of inefficiency and waste exist.What are the losses countrywide?  One hundred thousand dollars.? Half a million dollars? All for it’ty bit’ty errors.

       Costly inefficiencies are not limited to hospitals. More egregious ones can be found among insurance companies. My wife is a member of the Health Incurance Plan of Greater New York (HIP). Her monthly premium is $775.00.  Payments are regularly made by my bank five days before each due date, plenty of time to reach their office.  Almost every month, I get  a three-page letter advising me that the payment is overdue.  I promptly phone the billing inquiries office to check.  Usually,  I’m told that payment has been received. Sometimes, I’m told that they do not yet have a record of my payment, but not to worry. “The company post office is stacked up.” The billing screwup at the Hospital is only three or four times a year. The wasteful office, paper and mailing costs at HIP occur monthly.. At least ten times as much money is wasted  annually. I repeatedly ask HIP to fix this problem but get nowhere. I am sure I would get a similar dismissal at other insurance companies.

       I am certain that my it’ty-bit’ty waste is multiplied ten  thousandfold by other examples of a waste in the medical and insurance industries.

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Call it a moniker, a sobriquet, a diminutive or whatever, in everyday use, people tend to shorten the names of friends or associates, whether for informality’s sake or just for the heck of it. 

       As a word lover, I have always been intrigued by the fact that the same name, in its informal variation, has so many possibilities.. Why oh why do some people prefer one diminutive over another? And some resist any attempt to avoid using their full name? Following are 25 names with at least two frequently-used variations

Albert Al, Bert

Alexander Alex, Andy

Alfred Al, Alfie

Barbara Barb, Barby

Beatrice Bea, Bede, Trish

Bernard Bernie, Barney

Charles Charlie, Chuck

Deborah Deb, ,Debby

Edward Ed, Eddy, Ted, Teddy

Elizabeth Liz, Lizzy, Beth, Betty

Estelle Essie, Stella

Francisca Fran, Franny

Gertrude Gert, Gerty, Trudy

Herbert Herb, Herby

Leticia Letty, Trish,Tricia

Lillian Lil, Lilly

Margaret Meg, Margie

Morton Mort, Morty

Patricia Pat, Patty, Trish

Richard Dick, Rich, Richey, Rick

Robert Bob, Bobby, Rob, Bert

Roberta Bert, Bertie, Robby

Samuel Sam, Sammy

Sheldon Shell. Shelly

Thomas Tom. Tommy

       If your name is Richard, why do you prefer Dick over Rich ––or Rick or Richey –– or vice versa? Are you offended if someone shortens your name or uses a form you just don’t like?

       Only on occasion do I get an answer. My friend Deborah objects vigorously if you call her Debby. She thinks of herself as a serious, accomplished individual with a serious name. She thinks of Debbie as a brainless character, perhaps the subject of a movie entitled “Debbie Does Dishes.” My niece Judith hates being called Judy.  That’s what her parents called her when she was a child.  She is a grown-up now ––Judith, not Judy.

       Sometimes, people shorten your family name rather than your first name, My son Jonathan Rubinstein, a prominent businessman and engineer, prefers to be called Jon but never objects when many people call him Ruby Here’s a funny observation. Some nicknames or shortened forms skip a generation.  My father was called Ruby, but nobody used that name for me. However, Ruby was resurrected for one of my sons. Not for the other.

Go figure.

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A recent NY Times piece discussed the dangerous resentment and hatred that many Americans have for highly educated affluent women, who presumably think they are better than “normal” Americans. While in full agreement with these observations, this author wishes to point out that bright and educated American men are also subject to similar erroneous resentments.

       Many years back, I was attending my second class at the evening division of Brooklyn Law School. In our first session, we beginner students had been asked to read a test law case and bring back a written analysis of the points we should consider if we were handling the defense. Evening classes usually attract  mature students, so almost all of us were in our twenties or thirties.To the best of my knowledge, none of us had any legal background.

       I prepared an extensive paper covering what I considered the pertinent facts, my opinion as to what laws I believed would apply and a discussion as to how I would handle the case. Several of us were asked to read our papers to the class..  Most of the reports were short. Mine was extensive and I believe thorough. When I finished reading, there was a moment of silence in the class, followed by copious  laughter.

       The Professor spoke out, “See, Mr. Rubinstein, realize that if you are bright and work hard, you will face resentment, often masked by  laughter and ridicule.” 

       What was true in that class is equally valid for our whole country. A substantial portion of the population, while not stupid, are relatively ignorant and choose to remain so. They feel nervous when dealing with bright and educated people,  particularly intellectuals. Note the popular use  of words such as egghead, bookworm, nerd, elitist, intellectual snob and wiseguy, all used in a derogatory way. Apparently, nobody wants to think of himself as intellectually inferior. “I’m as good as the next guy.” “Why should he get special treatment?”It starts in school.  The smartest guy in the class is rarely popular. It’s the jocks who rule the roost. Or the most beautiful and the most handsome. [As we grow older, another popular category is added –– the richest.]

       This explains why very intelligent candidates, e.g. Adlai Stevenson, rarely are elected President. The average voter prefers a George W. Bush type, someone you would rather share a beer with.. someone who reads cowboy novels, if he bothers to read at all.  Or, more recently, someone like Sarah Palin. Harry Truman concealed the fact that he was a closet reader, particularly of history) until after he was elected President. The real brains in the Government  are for the most part appointed, rather than elected.

       This anti-intellectual snobbery is strange, since many of the things we  enjoy in modern life originated with brain power. Mediocre or average guys do not invent or create light bulbs, automobiles, refrigerators, air conditioners, radios, TV’s ,computers, and many of the other devices which make life easier for most of us.  Nor do they improve our medical treatment with X-rays, E.K.G.’s, MRI’s, prosthetic devices and a wide array of pharmaceuticals. Louis Pasteur invented pasteurization. Jonas Salk discovered a vaccine to prevent Polio. Hundreds of thousands of lives were saved by these two brilliant men.We all enjoy the fruits of these inventions and  improvements. They are part of our daily lives.  But it is surprising how many of us sneer, either openly or subconsciously,  at the class of individuals who invented them. 

       This open resentment against intellectuals and against brain power in general is dangerous. Years ago, I visited the Tykai Pyramids in Guatamala, once the center of a magnificent and advanced Mayan civilization, now just a set of deserted ruins. I asked the guide what catastrophe had destroyed this society. He advised me that nobody knew for sure, but a likely theory is that the common people, the workers revolted and killed off the ruling class. In their anger, they also killed the engineers who were responsible for maintaining the water supply, so necessary in that arid area.  Without proper maintenance.  the water supply eventually disappeared, and the population had to move to another area.

       I am not in any way suggesting that America is in danger of an uprising by ordinary citizens against the intellectual elites. I do however believe that resentment and hatred of the bright and educated members of our society, now more or less socially acceptable, is an unhealthy situation, not in the best interest of progress.

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Political fearmongers are at it again. I refuse to be swept into the penumbra of their virtual fears. I carry on my day-to-day a activities in a normal manner. I travel almost everywhere, atany time. Have I lost my mind? No, but I have taken a course in statistics.

         I have a niece who tells me that she doesn’t believe in statistics. That’s sort of like doubting the theory of evolution. I ask my niece (and others like her) to toss a coin in the air 1,000 timesand see how many times it turns up heads and tails.

         How many people died on 9/11? Using round numbers, about 3,000. What is the population of New York City? Somewhat over 8,000,000 , not including the suburbs. This means that I, as an individual, had a statistical chance of being killed during 9/11 of 3,000 divided by 8,000,000 or roughly one chance in 2,700, a little over 0.0001 percent. This is probably less than your chances of dying by slipping and falling in your bathtub.

        So, why the panic? Of course, one should take normal precautions at all times. But, even ifthere should be another terrorist strike here, the chances of my being killed (or your being killed) are infinitesimally small. The people of Israel realize this; their reaction to suicide bombings is totake precautions but get on with their lives. To do otherwise is to let the terrorists win.

        The intensity of fear is pervasive. Some trepidation in New York or Washington might beunderstandable. But for people in Sandusky, Ohio and Paducah, Kentucky to tremble in their bootsis nothing short of ridiculous.

        What about fear of flying? The number varies at different times and seasons, but approximately 5,000 aircraft are in the U.S. Skies at any given moment. Should any plane be blown up by terrorists, the chances of my being on that plane is one in five thousand or 0.02 percent. Unless I fly frequently, it is less than that. Even assuming that the recent plot in Britain had succeeded, the chance of my or your being a victim is less thatn .002 percent. And that’s only if you fly frequently from London to a U.S. Destination. Besides, the terrorists never got away with it.

        In spite of these abysimally small odds, hundreds of thousands –– perhaps millions ––  of Americans are fearful of flying They limit so many of the pleasures available in life by refusing to board a plane. This is silly. Worse yet, these same people do not hesitate to drive 500 miles to visit Uncle George in Chicago, a motor trip with far greater opportunities for tragedy than travelling by plane.

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