The book of the year?

The price we pay book cover
Lots of books are published each year, and I can only read a few of them. But, when a really important general interest book comes along, I often put it on the top of my “to be read” pile. In September, Dr. Marty Makary, a surgeon associated with Johns Hopkins, released a book entitled The Price We Pay: What Book American Healthcare—And How to Fix ItSince most people in America eventually get sick or have an accident, and only a few of us are fifty rich, this is the ultimate general interest book.

In Part I, entitled “Gold Rush” Makary doesn’t have to travel far—he visits “health fairs” at local churches, where salespeople disguised as medical professionals do screening tests and scare participants, mostly those on Medicare, into unnecessary and rather expensive procedures, such as placing stents into leg veins. In the second chapter, he discusses the lack of transparency in hospital pricing, as well as the astronomical rise in common procedures. For instance, a medical center in New Jersey offers joint replacement surgery for $135,400.00, which rose a mere 76.8% in a single year. BTW, Medicare only pays 13K for that procedure. For his third chapter, Makary travels to Carlsbad, NM, where the medical center seems to have overcharged and then sued almost everyone in town. Back in Virginia, Makary visits the courthouse to learn more about similar shenanigans at Mary Washington Hospital in Fredericksburg. Sadly, this hospital is supposed to be a “not for profit” hospital, and thus receives favored tax status, too. Also in this section, Makary provides an analysis of the proliferation of for profit helicopter ambulance services, which charge somewhere between $40K and $60K for a ride that I could make in an hour in my Toyota.

In the second portion of the book, Makary delves into some medical practices that can be improved by focusing on individual physicians. One OB doctor in Florida had a reasonable rate of C-sections, until figuring in Fridays, when the rate rose 80%. Why? The good doctor didn’t want to be bothered on the weekend, so moms who were in labor on Friday got the surgery. This section of the book also discusses the opioid crisis, and Makary admits that he had to learn to write fewer prescriptions for pain pills, after learning about the misuse of all those pills.

Part III of the book is about “Redesigning Healthcare” and it does offer several solutions to problems, but one chapter in this section explains how drug prices are affected by middle men (pharmacy benefits managers) who don’t supply anything other than a big bill for their services. Here’s an example: A pharmacy is paid $34.94 for 90 40mg doses of Zocor, but the employer is charged $442.85–and the PBM gets over $400 on that one transaction. Another chapter discusses problems in health insurance, which less and less helpful except in catastrophic circumstances, and there is even a chapter on “wellness” and how those well meaning programs are far too costly, especially as they often mean an invasion of privacy, or worse, over-treatment for minor issues.

Makary doesn’t make the mistake of only discussing problems without discussing solutions. Several positive programs are mentioned throughout the text, including websites such as ImprovingWisely.com, and the last chapter is a bit of a call to arms. In short, legislators and employers need to be educated on these matters, and healthcare consumers should do everything possible to demand transparent pricing for upcoming procedures.

The Price We Pay is a very important book. This should be the topic of your next book club, a gift for your friends and/or family, or even a holiday gift for your doctor or your legislator. Please buy this book, read it, and pass it on. Knowledge is power, and as this text has lots of information for Americans, this may well be the most important book you will read this year.

My video is reaching students!

NASA nebula

A still shot from NASA

Way back I took classes in “podcasting” and “movie-maker.” Afterward, I came home and practiced what we’d learned in class. I made three videos, which are a lot closer to Powerpoint presentations, if the truth be told. Anyway, one of them has had a bit of success—”A Brief History of Science Fiction.” This video was designed with a few still images, mostly screen shots from NASA such as the one I featured on this post, and two audio tracks. We’d been warned in class about using commercial music, so I downloaded a freebie track that I thought sounded dramatic. The second audio track is my voice, reading story boards, in my rather strong Southern U.S. accent. I did write the story boards, based upon my study of the science fiction genre, my training in English literature, and what of that matched up with the still images that I managed to acquire at the time.

Science fiction is an ever changing literary and film genre (with more than a dash of animation) so my video is already a bit dated. Still, I was most gratified when reading a very valid complaint about the loud musical soundtrack. The complainant stated that my little YouTube video was required for class. Gosh darn! My Brief History of Science Fiction is required by a teacher (somewhere?) for a class (in something?) I’m flattered. Really.

If you don’t mind hearing that awful musical track, head over to YouTube and see A Brief History of Science Fiction. While you are there, the link to my “book trailer” for The Gift Horse is still live also.

Thoughts on Car Buying

2000My sometimes hated (but mostly beloved) minivan is no longer in my possession. After a few days of car shopping, I traded it in for a used Toyota. The van, a Honda Odyssey, was sixteen years old, so I suppose it was time. Still, it ran beautifully on the way to the dealership, so that drive was bittersweet. On the way, I passed by a yard sale, offering bikes and other things I might have purchased, because having things to do at Grandma’s house is where I am in life, but I didn’t stop, knowing that those items would probably not fit in the trunk of the sedan I was planning to purchase.

Buying a car has changed since I bought my first vehicle, that’s for sure. Now, the first contact is often online. Whether one picks the “chat” function or sends an email, there will soon be a contact. The phone starts ringing. Go in for a test drive, and (in Athens, Georgia) there is a mandatory meeting with the “sales manager.” Then, a couple of times, I got an email to see if the salesman met my expectations.

After I finally said I might be interested in a used Honda, I got an offer of $500 for my old van. As it has been more truck than family vehicle for a while, with the typical bumps and scrapes associated with that duty, I wasn’t expecting much. But, that deal had me paying more than the maximum KBB value on the seller’s car, with half the typical auction estimate on mine. Really, that wasn’t what I wanted to hear.

Eventually, I ended up at a more rural dealership which didn’t use the “meet the manager” approach. I got $900 for my old van, which was still a very low number, and a newer car for less money. Oh, and I got to keep the new to me car overnight and take it for an inspection prior to purchase. The dealer even gassed it up for us before the extended test drive.

After I’ve had this vehicle for a while, I guess I will know if it was a good purchase. But, I can say that the pressure to buy was less out in the country. In the mean time, I guess I’ll be looking for some accessories for the “new to me” ride.

Fatal Boarding— a review

Cover, Fatal Boarding

Fatal Boarding is better than the cover would suggest.

Recently, I read E.R. Mason’s science fiction novel, Fatal Boarding, via the Kindle app. As of this writing, it is a bargain because it is free. And, normally, if I don’t particularly like a freebie, I do not review it. I did review this one, on Amazon, and I am going to do so in a more elaborate manner here, because I did like it, but with reservations.

Why did I “buy” it in the first place? The cover is pretty bad, I think, but the number of reviews and stars is impressive. Also, you can’t beat free. So, I added it to my Kindle library, and I did manage to finish it, although I thought of abandoning the effort more than once. The main character isn’t likable, at least not a first, but he did grow on me. The situation is interesting, and the author does a good job of putting in details to help the reader visualize both settings and characters. Actually, the plot line isn’t all that fresh. However, just about every story has been told by now, so all we readers (and writers) have left is theme and variation.

Adrian Tarn, main character, is an experienced spacer, currently serving as security officer on a ship that has a boring task, mapping. He signed on because he lost too much money gambling, and at least a portion of his grumbling is probably intended as foreshadowing. Anyway, his rather boring job is interrupted when his ship goes a tad off course to investigate a derelict alien vessel. The reason this other ship is abandoned is a bit of a mystery, and solving this mystery becomes imperative when Adrian’s ship has malfunction heaped upon malfunction, apparently all due to the close proximity of the mystery ship. Then, folks start dying, as the title indicates. So, this is a space mystery, which evolves along expected lines, as Adrian and his fellows begin to figure out how and why both vessels are dead in space.

Overall, I did enjoy the story, but the most troubling aspect is the lack of proper grammar, spelling, and/or editing. As a writer, I know it is hard to catch every little thing, especially when working on one’s own manuscript. But, Fatal Boarding suffers myriad problems, making this a distracting book to read. The author confuses “loose” and “lose” several times, and there are missing quotation marks, missing commas, odd paragraphing, and other issues. At times, I had to back up to be certain what was happening or who was speaking.

Yet, 145 reviewers have rated this effort 5 stars, and another 87 give it 4 stars. That’s 228 more reviews than my space story, Trinity on Tylos, has garnered during 8 years of publication.

I’m doing something wrong….

The Martian— a quick review and some commentary

The MARTIAN coverOften, I choose to read indie published books rather than those from the “big six” publishers, because I find the content of indie books to be a bit more raw, unpolished, and (sometimes) unique. Yes, I am disappointed from time to time (as in my previous post) but I keep trolling for new authors and books. However, recently, Goodreads sent out a newsletter and the science fiction book of the year was Andy Weir’s The Martian. The blurb caught my eye so I bought it, but didn’t begin immediately, as I was slogging through a book on SEO (search engine optimization) at the time. Over the weekend, I began The Martian, and I was hooked. Like from the first page, I was seriously into the story.

The plot is not a new one. An astronaut is marooned on Mars. His fellow crew members are on the way home, believing that he is dead. But, this astronaut is determined and a heck of an engineer, so he keeps finding ways to use what is at hand to survive. After a while, the NASA folks figure out he is still alive, so they are trying to figure out how to get him home. Yes, it is really suspenseful. But sometimes it is laugh out loud funny, because the main character is quite a character.

Actually, this book was so engaging that I began to question my quest for good indie books. If the big guys are publishing this kind of science fiction, then I should be looking at the best seller lists again. So, after finishing the book, I did a wee bit of research and learned that Weir’s book was originally self-published via Amazon’s Kindle Direct (yeah!) and only after it sold thousands (at 99 cents, because that’s Amazon’s minimum price) in the first three months did big publishing come calling. Now, it is the basis for a movie starring Matt Damon.

The book is cool. Weir’s evolution as a writer is seriously cool. Many of the self-published and small press published writers, including yours truly, would love to have this sort of rags to riches experience. The impediment to that is having a really great book. The Martian is such a book. So, my suggestion is read it now and try to wait for the film version. Gravity won an Oscar, so the way is paved for another near future space adventure to do well at the box office.