New Eyes

You're probably wondering why this guy is  smiling.

It's because after wearing vision-correcting eyeglasses since the fifth grade he's driving his Mustang while wearing a pair of uncorrected sunglasses that set him back a $1.50. 

Since I retired my annual visit to the eye doc has included monitoring the progression of cataracts that have conspired to degrade my vision.  Cataracts are a clouding of the natural lens of the eye, leading to blurred vision, glare, and eventual vision loss. This spring's routine visit resulted in sufficient advancement of the condition to do something about it.

I finally got my chance to get my eyes fixed.  Two visits, one week apart, to the Eye Clinic in Green Bay.   

Cataract surgery removes the cloudy lens and replaces it with a clear artificial intraocular lens (IOL).  And for me it opened up a world where everything is clearer, brighter and more colorful.  I didn't know what I was missing.

This is an outpatient procedure performed under local anesthesia with sedation (you’re awake but relaxed).  Most commonly it is performed with phacoemulsification (ultrasound to break up the lens), followed by IOL insertion.  Truthfully, the prep and recovery took up most of the time.  The procedure itself took all of ten minutes and required no eye drops in the follow-up care. 

By all outward appearances things were busy at the clinic.  Inquiring of the surgical staff I learned that there were four operating rooms and two surgeons performing, respectively, approximately 20 procedures each day of my visits.

Cataract surgery is the most commonly-performed procedure on the planet with over 3.7 million surgeries performed annually in the United States.  Over 20 million are performed globally each year and the number continues to rise due to aging populations.

Over 98% of surgeries result in improved vision and complications are rare and usually treatable. 95% of patients achieve 20/40 vision or better (good enough to drive without corrective lenses) and many achieve 20/20 with or without glasses depending on lens choice.

Best of all the procedure is covered by Medicare and my supplemental insurance policy.  Between you and me this is good government policy; trust me, you don't want millions of vision-impaired baby boomers on the road. 

At the present time both my eyes have been corrected to 20/20 vision so I went to the Dollar Store and splurged less than ten bucks for four pair of +1.75 reading glasses and a couple of plain sunglasses - one for each automobile.   My doc sez that I need to allow a month (give or take) before a final correction in vision can be confirmed. 

We are blessed to live in a Golden Age of replacement parts.

Storm The Bastille

On December 4, Brian Thompson, CEO of UnitedHealthcare, was shot and killed outside the entrance to the New York Hilton Midtown in Manhattan, NYC.  He was in town to attend an annual investors meeting for UnitedHealth Group, the parent company of UnitedHealthcare.

Authorities believe the attack was not a random act and are investigating it as an assassination.  The shooting occurred early in the morning and the suspect, described as a white man, fled the scene. As of the publication of this post the perp has not been apprehended.

No arrest.

No interrogation.   

No motive.

Plenty of speculation to go around.

It is unclear what motivated the incident or whether it was tied to Mr. Thompson's work in the insurance industry.  The police have yet to identify the shooter who is still on the loose.

Nevertheless, social media has exploded with an avalanche of vitriol, and glee over the murder of the insurance executive.  Sure, I get it.  People have had negative experiences with health insurance companies at some of the most difficult times of their lives.  But in the absence of the facts and circumstances of this killing has anyone considered taking a moment to take a breath and not get over their skis? 

I tried on a Face Book group to counsel restraint and got hammered.  I was slammed for not embracing the notion that a man responsible for millions of deaths of people for money got his comeuppance.  

UnitedHealthcare denied 32% more claims last year than any other insurer, it's not hard to figure out.

Posting a photo of Albert Bouria, CEO of Pfizer, from Prophetic Memetics someone else suggested that he just thought someone else might might be curious.  

Anybody else, beside me, consider that a passive aggressive threat instead of your garden variety internet troll?

It is interesting to me the instances of individuals who have flippantly shared that their grievances (large or small, real or perceived) are justifiably resolved at the point of a gun.

It is a chilling observation to note that killing someone for a slight, a political difference or an insurance dispute is justified. 

Regrettably, this is what can happen when there are no appropriate channels for people to make meaningful change to a malign system.  The Supreme Court has allowed unlimited money in our politics and politicians are voting with their corporate overlords, including health insurance companies.  

My sense is that government is broken and simply does not work very well for the average American.  As a consequence they despair.

If this shooter becomes a folk hero it will be appalling; but not surprising.  I have shared many times that capitalism is messy business.  Perhaps we've arrived at a Storm the Bastille moment where the murder of both oligarchs or a neighbor with an offending bumper sticker becomes normalized.

I sure hope not....

Noah Was Prescient

Recently I touched on the matter of climate risk and the implications this has for our choice of where to live, the market impacts on the price of our homes, the costs associated with insuring against large losses and the cumulative impact on our communities.  

As the chart implies the incidence of flooding continues to rise over time.   

The National Flood Insurance Program (NFIP) is broke.  In debt to the US Treasury to the tune of $20 billion, it is required to pay interest on that debt.  And the program's interest burden amounts to $309 million every six months - money that otherwise would go to disaster response.

The NFIP is over-subscribed by severity and increasing frequency of flood events.  The programs flood maps are outdated and do not provide data about specific location risks. And remarkably, Americans are increasingly moving to coastal and other flood-prone locations.  Stunningly, fewer and fewer of them are purchasing flood insurance.  The federal government issued just two flooding disaster declarations in 2000.  So far for this year along it has issued sixty-six.

This is nuts. 

Several weeks ago the New York Times covered the crisis America's flooding problem and the three responses Americans are embracing to it.  

Fight the Water

Construct walls, dikes, barriers, pumps and drains to keep the water out.  Think: Holland, Venice and New Orleans.  The problem with this is the hundreds of billions of dollars needed to build-out the infrastructure necessary to protect Miami and Manhattan from storm surges. Miami abandoned their plans.  The people didn't want to spoil the view. 

Live With It

Get used to the idea of water and live with it.  Spend the vast sums of money necessary to locate homes on utility poles and elevate (or move inland) critical infrastructure like power generation plants and water utilities.  Expand wetland habitat to soak-up inundations like a giant sponge.

Pack Your Bags

And beat it out of Dodge.  Retreat and relocate to another community away from the likely risk of storm surge and flooding.  When the reality of repeated losses and inability to obtain insurance at any cost sinks-in; the shear weight of economics will drive the people to the high ground.  Maybe we should simply stop building in flood-prone locations.

For your late-night reading are a handful of links with more on this topic.

This year the federal government restricted building in flood plains.

Just last month, climate-induced flooding impacted people across four continents.

There is a real estate boom in flood zones.  Here's why.