A Condition That Was Caught in Time

Pulmonary embolism (Cavallini/Science Source/WSJ)

I had been feeling pretty chipper until the beginning of September. As the month proceeded, my asthma got worse, and I could no longer take 30-45 minute walks in the morning. Last Monday I showed for a scheduled doctor's appointment; the nurse took my vitals and immediately called for oxygen.

The doctor strongly suggested that an ambulance transport me to emergency. Of course, my wife could have driven, but the ambulance had the necessary equipment and personnel if the situation worsened.

Over the next two days I was poked and prodded at Stanford General. There were ultrasounds, chest X-rays, CT scans, echocardiograms, and dozens of blood draws. The good news was that most of the tests were negative. I was short of breath because the asthma had been exacerbated by a blood clot that had formed in the right lung. I will have to take the blood thinner Eliquis indefinitely. I was discharged Wednesday, and my condition wasn't serious enough to warrant being on oxygen at home.

Considering the possible outcomes, I was pretty lucky:

About 900,000 people are diagnosed with blood clots—deep vein thrombosis or pulmonary embolism—in the U.S. each year, according to the American Lung Association. For many, the first symptom is sudden death.

“I call it the people’s disease. It doesn’t spare anyone—rich, poor, male, female,” says Dr. Parth Rali, director of the pulmonary embolism response team at Temple University Health System in Philadelphia... “You could be the healthiest person in the world and unfortunately it can still happen to you.”

Some lifestyle factors increase your risk of blood clots, such as obesity and smoking....Dehydration can thicken the blood. And taking hormonal contraceptives... also raises the risk.

Then there’s movement, or lack thereof. When your legs stay still for too long, the blood may begin to form clots, which can then travel through the heart and into the lungs.

Yes, more things to worry about, but better than the alternative.

A Financial Hit That Few Budget For

Christine Salhany spends about $240,000 a year
for 24-hour in-home care for her husband, Jimmy,
who has Alzheimer’s.(WSJ)

Everyone in my boomer circle of friends and relatives has been hit by the cost of caring for a loved one; it could be a parent, a spouse, or even themselves. It's a crushing financial burden: [bold added]

Americans want to grow old in their own homes. But pursuing that dream has gotten harder, and is putting huge financial and emotional strains on families.

In Nebraska, Christine Salhany spends about $240,000 a year for 24-hour in-home care for her husband who has Alzheimer’s. In Illinois, Carolyn Brugioni’s dad exhausted his savings and took out a home-equity line-of-credit to pay for home healthcare.

Traci Lamb closed her business to take care of her mom in Florida. And in California, Cheryl Orr delayed retirement to help pay for care and home modifications for her wife, who has dementia.

Soaring costs of in-home care, medical advances that extend lives but require ongoing help, and the growing ranks of older baby boomers are creating new pressures. Spouses, adult children and siblings are putting their lives on hold to care for relatives, wrestling with sleep deprivation and constant worry. Families are draining savings to hire help, pay for medical care, and modify homes...

The cost of paid in-home care has soared in recent years. The 2023 national median cost of a home health aide, hired through an agency, stood at $33 an hour, up from $20 an hour in 2015, according to Genworth, a long-term-care insurance company. Those needing round-the-clock in-home care can expect a median cost of about $290,000, which is more than double the annual median cost of a private room in a nursing home facility and four times the annual median cost of a private room in assisted living, according to Genworth.

Very few elderly have the nearly $1,000,000 in retirement savings to pay for long-term at-home care for, say, four years. Borrowing against, then selling the family home is an option if the patient is willing to move to assisted living.

I know three families that have tapped the value of their house; they were fortunate to have lived in the Bay Area, where suburban tract homes have appreciated by over a million dollars if held for at least 20 years. They have had to move away but consider themselves lucky to possess such a valuable asset.

If any politician can come up with a credible solution, he or she would win in a landslide.

There But for the Grace of God Go I

Everyone I know has had a family member--sometimes it's my acquaintances themselves--who's had cancer. Whether or not the patient survives, it's a grueling experience for everyone. Years of tests, chemotheraphy, surgery, and/or radiation, plus the financial strain of paying for everything, await.

Fortunately--I realize that's not the appropriate word--most of the cancer victims I'm familiar with were retired or close to retirement, which means that they had Medicare or other health insurance to absorb most of the costs, and they probably didn't need to work to make up money shortfalls.

There is a growing cohort of Americans who are diagnosed long before retirement age, and, even if they survive the cancer, experience financial ruin. [bold added]

The economic burden of a cancer diagnosis is getting strikingly worse in the U.S., as drug and medical costs soar and more patients live longer with the disease. About 55% of cancer drugs introduced between 2019 and 2023 cost at least $200,000 a year, according to Iqvia’s Institute for Human Data Science. And an increasing number of patients are working-age, a group more likely to report financial hardship after diagnosis compared with older adults.

Nearly 60% of working-age cancer survivors report facing some financial difficulty. Many patients struggle to afford care and end up taking on debt, with some getting payday loans or running up credit cards. Cancer alone accounts for some 40% of medical campaigns seeking financial help on GoFundMe, research shows...

Among common diseases, cancer creates a uniquely difficult financial strain known as financial toxicity. Treatments with expensive medicines start immediately and come with a string of nonmedical costs. Chemotherapy and other treatments can leave patients too weak to work for weeks or months. This can result in a twofold blow, with patients losing income and their employer-sponsored health insurance. The financial fallout can last for years...

Many patients have to take time off—or actually stop working—after a cancer diagnosis. Patients who get chemotherapy are more likely to stop working within four years than those who don’t.

Could one straightforward way of relieving the financial burden be to buy up medical debts--for cents on the dollar because they've been sent to collections--then forgive them?

Undue Medical Debt (aka RIP Medical Debt) does exactly that--it's rated four stars by Charity Navigator--and is a 501(c)(3) organization that my church has donated to. RIP Medical Debt opened its books to economic researchers to find out whether paying off medical debt made a difference in people's lives. The results were disappointing:

[Stanford Prof. Neale] Mahoney and his collaborators find no evidence that buying and then forgiving medical debts that are in collections improved on average beneficiaries’ finances, access to credit, or their physical or mental health. People were even less likely to pay existing medical bills after their debt was eliminated.

Prof. Mahoney and other researchers, as well as RIP Medical Debt, are studying if earlier interventions might be more helpful.

Meanwhile, we're just lucky that we were able to enjoy good health during our working years. If either of us had been diagnosed with cancer in our 40's and 50's, when we didn't have much savings and had mortgages and tuitions to pay, then our lives would be immeasurably more difficult.

San Mateo County Fair: Senior Showcase

The Senior Showcase was one of the busiest exhibits at the San Mateo County Fair. Businesses and government agencies answered questions about assisted living, Medicare and senior health insurance, reverse mortgages, medical equipment, and veterans benefits.

The themes of disability and decrepitude were covered thoroughly, as was the Big "D" by the presence of cemeteries and funeral homes.

I've never noticed an exhibit like this at a fair, probably because I wasn't looking for it. The merry-go-round and Ferris wheel period of my life went by too quickly.

They'd Rather Curse the Darkness

Church-state frictions manifest across many cultural touchpoints, but this is a new one:

The sanctuary candle: dangerous to the hospital (CNA)

Feds tell Catholic hospital to blow out sanctuary candle or face penalties

The federal government recently told a Catholic hospital in Oklahoma to either blow out a small candle or stop serving elderly, disabled, and low-income patients...

Saint Francis Health System is a premiere health system with five hospitals in Eastern Oklahoma. The health system cares for nearly 400,000 patients each year, has given away more than $650 million dollars in free medical care in the past five years, and employs more than 11,000 Oklahomans...

Since Saint Francis opened its doors in 1960, the health system has had a sanctuary candle with a living flame as an act of worship. The flame, far removed from medical equipment and patients, is shielded by two glass holders, sits on a brass basin, is affixed to a wall and has a brass top covering it, with many sprinkler heads above it...The federal government now threatens to tell all patients who rely on Medicare, Medicaid, and CHIP that they can no longer receive care at Saint Francis—all over a candle.

After the hospital's lawyer responded, the government retreated:

The hospital was informed that it will receive a waiver, provided it posts signs warning about keeping oxygen equipment away from the tabernacle candle, which is already enclosed and on a wall six feet off the ground.

IMHO, government employees could not possibly have believed that a single candle posed a danger to thousands of Medicare, Medicaid, and CHIP (Children's Health Insurance Program) patients. This was a demonstration of power that showed that even minor disputes with the government can be costly. And no, Catholics, you're just imagining that this is retribution for your stances on abortion and same-sex marriage.

One thing is certain: Florence Nightingale, aka "the Lady with the Lamp" and founder of modern nursing, would have been persona non grata on battlefield hospitals if these bureaucrats had been around in 1854.

Age is Not Just a Number When Benefits Are at Stake

The Kobayashis--Yuichi (retired), 67, and Sachiko, 64,
-- work part-time and full-time, respectively. (WSJ photo)

"Japan is by far the world’s oldest nation, with more than 29% of the population 65 or older" but has figured out a way to solve the problem of too many old people: [bold added]

Japan is at the forefront of change. Millions of people have learned they no longer are old, but merely “pre-old.”

That is the terminology suggested by both the Japan Gerontological Society and the Japan Geriatrics Society, which say the 65-to-74 range now should be called “pre-old age.” The government says the idea is worth looking at and has modified its annual White Paper on the Elderly to make clear it isn’t necessarily calling people in their 60s elderly.

While being called "pre-old" is complimentary to 65-74 year olds who practice good health habits, Japanese are suspicious of the motivations behind the word change.

Among the pre-old set, fear remains that the redefinition, even if advocated only by independent bodies, simply encourages the austerity-minded Ministry of Finance to slash benefits.

Meiko Yamamoto, 74, who works at a medical-clothing factory, said she agreed that many people remained active at a more advanced age these days, but she said wider recognition of that might lead to an unhappy result. “I suspect the government is likely to delay offering pensions,” she said.

Americans would be immediately on their guard if the Federal Government initiated a "pre-old" demographic classification. Because of a long history of instituting vocabulary changes to prepare people for real policy changes, most elderly will gladly accept the tradeoff: continue to call us "old" but don't you dare touch our Social Security and Medicare benefits.

Wealth Survey

On a day like this I feel wealthy, and it's not from owning one of those houses.

Eighteen years ago my work colleague, Phil, and I were musing about retirement over a beer. The question before the panel: what should our financial situation be to have a comfortable retirement? The initial bid was $1 million + a paid-up house + Social Security and Medicare coverage.

Then we thought about the traveling we would like to do, the 3-years-old-or-less cars we would like to have in our driveway, and the need for long-term care, and the bank-account objective was raised to $2 million, which is easy to do when the sun is shining and you're on your third beer. The conversation was only half-serious--after all, we weren't yet on Medicare--so we had to keep working anyway.

In the intervening years Phil retired, sold his Bay Area house, and moved to Palm Springs. Whether he hit the goals we set on that distant afternoon, I don't know, but I hope he's happy. Happiness, and its relationship to wealth, is a subject more for philosophers, psychologists, and priests than accountants, but we hone in on wealth because financial measurements are objective and easier to obtain.

In the Bay Area one needs to have $3.8 million to be "wealthy". [bold added]

Respondents to the 2021 Modern Wealth Survey from Charles Schwab said it takes an average net worth of $3.8 million to be wealthy in the Bay Area, down $700,000 from $4.5 million in 2020. If you’re just aiming for “financial happiness,” that carries a price tag of $1.8 million in 2021 compared to $2.1 million in 2020.

A mere $1.3 million is enough to make you “financially comfortable” in 2021, versus $1.5 million in 2020, according to the survey responses.

Speaking from personal experience, I can tell you that "financial happiness" was not achieved at $1.8 million (the Schwab survey amount includes one's house).

While having enough money to make ends meet is necessary, it's not a sufficent condition for happiness. For that you have to look elsewhere, maybe in Palm Springs.

Reducing the Risk

Another precaution against the coronavirus' impact--assuming exposure is inevitable--is to inoculate oneself against the flu.

How many times, dear reader, do you hear about someone dying, say, of a bacterial infection, a weakened heart, or the flu after he or she is admitted to the hospital for something else? Chances are much improved if you're fighting off one malady, not two.

I headed to the local Costco Pharmacy. The pharmacist said the flu shot was covered by my prescription plan and asked if I would like a pneumonia injection as well. Can I get it today? "Yes."

And so it was that I got the flu shot and Prevnar 13, with a reminder to come back in a year for Pneumovax 23. (The pneumonia protocol is two doses.)

I looked at the chart on the wall and realized the pharmacist was following the CDC vaccination schedule recommendations. It may be standard operating procedure, but I'm glad she inquired about the pneumonia vaccine.

Can I get the shingles shot ("Zoster"), too. "No, that's on backorder." I was pleasantly surprised to get above what I asked for, but it didn't stop me from asking for more.

NEMT in Need of Disruption

Dad with his walker at Ala Moana (2012)

I haven't used Lyft or Uber yet, but their NEMT (Non-emergency Medical Transportation) service looks promising: [bold added]

An estimated 3.6 million Americans a year miss medical appointments due to unreliable transportation, costing the U.S. health-care system roughly $150 billion annually, according to Uber, citing independent studies. The U.S. Government Accountability Office pegged spending on NEMT under Medicare and Medicaid at nearly $3 billion in 2013. As the start of this year, supplemental benefits to Medicare Advantage were broadened to include a range of medical transportation that supports overall wellness and health—even rides to some massage appointments.

When we were unavailable to take Mom or Dad to their appointments, we tried hiring companies who specialized in NEMT for the elderly. The results were disappointing; my parents always felt rushed, and drivers didn't seem to be interested in alleviating discomfort. Plus it's costly, because the companies require us to pay for the vehicles to wait around during the appointment.

We family members know how to collapse and set up their wheelchairs and walkers, as well as assist the patients into various sedans. There's no substitute for family drivers' TLC, but hopefully Uber and Lyft can disrupt the NEMT status quo and give us better quality at a reasonable price.

Urgent Care Visit

The only blue pills I'm taking

When I arrived in Hawaii a week ago, a cyst that had been stable became inflamed. Expanding to the size of a silver dollar, the cyst had turned purple with a flat bubble of white cells on top. (Out of kindness to you, dear reader, I will not post a picture.)

In pain but not wishing to risk absence from the past week's birthdays, I went to Urgent Care yesterday. The doctor injected the area with painkiller, sliced open the cyst, squeezed out 20cc's of liquid, and packed the wound with gauze strips.

He prescribed the antibiotic Clindamycin to be taken over the next 10 days. I'll have to follow up every 2-3 days with a doctor in Hawaii or California to re-dress the cyst until it heals. Medicare and Medicare supplemental insurance covered the cost completely, while the Part D plan reduced the Clindamycin cost to $12.83. In retrospect I could have seen the doctor sooner, but it worked out well in the end.

Note: some politicians are touting "Medicare for all" as a solution to national health care woes, but the coverage is not "free" and requires monthly payments to 3 separate parties. Mine are: CMS--Center for Medicare and Medicaid Services $135.50 + Medicare supplemental--Blue Cross Blue Shield $171 + Part D--Silverscript $34.80 = $341.30. Sure, many new subscribers will buy in, but many won't or can't pay. Medicare-for-all is a solution that will foster more problems requiring $billions more, but I suspect that the advocates know that.

The Need Appeared Genuine

The ER waiting area on a Saturday night

A friend of ours is on a tight budget. And she's possibly hypochondriacal---though having witnessed supposedly mild diseases and injuries cascade catastrophically in the aged, I'm beginning to feel that way, too.

She said that she had a pain in her abdomen--on her left side, so it wasn't appendicitis--and needed to go to the Sutter Hospital emergency room.

From Safeway in Sacto: Dinner
and snacks for the trip back

No, an ambulance was too expensive, and she had trouble activating Lyft, which her Medicare Advantage plan said they would pay for if she could only figure out how to use it. Her siblings lived outside California, and, having moved a year ago, she had no friends nearby.

I packed an overnight bag. Our friend lived near Sacramento, 2½ hours away. True, I'm easily manipulated, but the need appeared genuine.

Arriving, I asked how she was feeling. The pain wasn't crippling.

She walked me through the instructions on how to take care of her dog and small animals in case the doctors wanted to keep her overnight. She kept using the phrase "if I should die", which seemed overwrought since she was moving about her house with twice as much energy as I. All the same, the prospect of tending to her pets long-term added fervor to my appeals to the Healer in the Sky.

At Sutter Hospital my friend 1) waited an hour, 2) gave blood and urine samples, 3) waited another hour, 4) had her abdomen scanned, 5) waited some more, and 6) was released after a final interview . The diagnosis was dehydration and constipation. All told, she was very lucky. The entire process took five hours, and the doctors didn't find anything that merited hospitalization.

She disagreed with the diagnosis. She assured me that she wasn't constipated. You should see a gastroenterologist, and you should get a colonoscopy. (She had had a bad experience with one years ago and had never been back.) Okay, but the procedure is much easier nowadays. Please think about it.

I am not eager to repeat this experience, but if she does have a colonoscopy I'll drive up to take her.

But They Meant Well

(Image from verywell.com)

Staying in bed doesn't help recuperation; in fact, immobility harms: [bold added]

Numerous studies have shown that immobility increases the likelihood of muscle atrophy, blood clots, bed scores and delirium. For elderly or very sick patients, the danger is even greater: Being immobilized even for a few days can lead to a permanent functional decline, making it more difficult for patients to return home.

Why then, don't hospitals encourage mobility? Because hospitals are penalized for falls.

CMS [Centers for Medicare and Medicaid Services] may have inadvertently exacerbated the immobility problem in 2008 when it stopped reimbursing for fall-related injuries having decided that patients should “never” fall within a hospital. Two years later, the Affordable Care Act began financially penalizing hospitals with high fall rates.

...hospital administrators, focusing on reducing the number of falls, put pressure on nursing staff. The units and nurses under the most pressure ended up confining patients to beds or chairs and sometimes even monitored patients while they were on the toilet, lest they or their unit be seen as negligent.

The people who administer Medicare, Medicaid, and ACA meant well by trying to reduce patients' falls and instituted penalties into the compensation system in 2010.

But if the system is found to hurt rather than help, why does it take so long to change?

Global Warming: Bug or Feature?

Adding to the litany of woes for climate-change alarmists: (bold added] 

the Nature study showed that 80% of Americans live in places that regularly receive better weather than 30 years ago, using those preferences as a baseline. That’s because winters so far have been warming disproportionately than summers, so Americans have gotten to enjoy less cold winter months without—so far—having to experience equally extreme summers.

Global warming has made winters less cold (good), while summers are not that much hotter (not-so-bad). The foolish public, reveling in the warmth. Doesn't it know what's in its best interest?

The result of this survey was predictable based on the public's reaction toward warnings in another important area. After years of hearing that the financial sky was falling (Medicare is insolvent, Social Security is going bankrupt), Americans stopped believing, or perhaps caring, about financial doom. Maybe the government will indeed run out of money (whatever that means) in 20 years, but the majority seems to have decided to let tomorrow take care of itself.

As for sea level rise in eighty (80) years, that's tomorrow's tomorrow.

In most counties (including ours) the weather has become more pleasant (Time graphic)

We'll Probably Put it Off Until It's Too Late

Barron's graphic.

During the golden years you need a lot of gold [bold added]:

the reality is that about 70% of people over the age of 65 will need some sort of long-term care, ranging from assistance with dressing and bathing to medication management and skilled medical help....the median annual cost of a private room in a nursing home is $91,250. The median cost of a one-bedroom in an assisted-living facility is $43,200 for a year.

Every senior I know wants to stay in his or her house, with home-health care, as long as possible ("aging in place").

The rule of thumb for moving: “Once you go beyond needing six hours of care, you are getting to the point that assisted living may be less expensive."

There's much more information in Barron's about the costs and benefits of various long-term care alternatives. The important take-away is this: seniors and their families should have the conversation now rather than make hasty decisions in the midst of a crisis.

LabCorp: Investor Beware

We've been customers of Laboratory Corporation of America (LabCorp, ticker: LH) for nearly 20 years, ever since LabCorp began offering

hundreds of tests on blood, tissue, urine, and worse [blogger's note: the Barron's columnist's diffidence is charming], generally providing results within 24 hours, using 39 primary labs across the country and 1,750 patient-service centers.

LabCorp's rates are a fraction of those charged by hospital labs. It has been a preferred provider in every medical insurance plan we've participated.

Barron's likes LabCorp's positive fundamentals: increased demand for services, Medicare's greater scrutiny that favors low-cost providers, synergies from a recent merger, and overhead cost-cutting. And LabCorp has a history of outperforming the stock market (chart below).

LH's appreciation is double that of the S&P 500 over the past 10 years.

LabCorp has a great story, but I'm not planning to invest. Technological disruption is looming.

Item: A cheap new test can reveal every virus that invaded you—and help stop infections. The cost is $25.

Item: Palo Alto-based Theranos can run hundreds of tests quickly using only a few drops of blood. Theranos testing is already available at Walgreen's.

LabCorp's business model is vulnerable. Investor, beware.

Good News from an Impressive Work

The good news [bold added]:

Medicare will be able to continue paying full hospital benefits for its elderly or disabled clients without any changes in the law through 2030.

The not-so-good news for those who collect disability payments:

the Social Security disability-insurance program....will be able to pay only 81% of benefits starting in late 2016 unless Congress intervenes. Roughly 11 million Americans collected a total of $140 billion in Social Security disability benefits last year.

The first selfish question that arises in the mind of every reader, including your humble observer, is: how old will I be when the money runs out for the programs that affect me? The reaction may be relief or despair, but either way, through the mechanism of government or the ties of family, our children will be taking care of us.

By the way, the 2014 Social Security trustees' report is an impressive work. One can quarrel with its assumptions and calculations, but the report incorporates all the factors (mortality rate, immigration, economic growth, fertility rate, etc.) that should be considered in this complex analysis.

He'll Be Fine, Probably

If he read all this stuff, he wouldn't have any sales

My friend is the sales rep for a foreign company which does business in Silicon Valley. He has one employee. The Fremont sales office is a simple, two-person operation, and my friend dutifully complies with government rules as best he can.

I look at the government paperwork---paperwork (labor, environment, taxes, licensing, etc.) which has nothing to do with making sales or keeping his customers satisfied---and marvel that he's able to meet his quotas.

My friend talks about retiring in California. Like many others, he loves living here, but running a business gives him headaches. Well, if he gets a good medical plan, he'll be fine.

The Fiscal Cliff is Not the Real Problem

The Government balance sheet

As Washington works through the weekend to avoid the fiscal cliff, U.S. News editor-in-chief Mort Zuckerman says that the current budgetary woes (the U.S. budget deficit for fiscal 2012 was $1.1 trillion) are dwarfed by the liabilities that the U.S. government is adding each year [bold added]:

Today the estimated unfunded total is more than $87 trillion, or 550 percent of our GDP. And the debt per household is more than 10 times the median family income.

.... the real annual accrued expense of Medicare and Social Security alone is $7 trillion. The government's balance sheet does not include any of these unfunded obligations but focuses on the current year deficits and the accumulated national debt.

The government balance sheet is not only less transparent, but misleading for not including material obligations (below information obtained from 2011 GAO report) that any private-sector entity would be prosecuted for omitting.


If there's one New Year's hope that your humble observer has for public governance, it's that legislators and the public have better information to gauge the consequences of their decisions. One place to start would be in government reports that are held to the same requirements that are demanded for the rest of us. © 2012 Stephen Yuen

One Happy Occasion

Still happy after all those years.

Today is Mom and Dad's anniversary, and they're still going strong. In fact, they're looking better than ever due to a change in their medication regimen and physical therapy.

Three cheers for their doctors, pharmaceutical companies, Medicare, and the Hawaii Medical Service Association. The existing system for elderly health care has served our family well, and we are willing to kick in more if we have to, just don't change or jeopardize its basics.

Life is good. Happy Anniversary, Mom and Dad.

Relieved and Guiltless

Some of the people in my circle have formed a very negative attitude about the Tea Party movement which is attracting adherents across America. Tea Partiers thus far don’t seem to have developed a fully consistent set of ideas (government’s too big, don’t raise my taxes, but don’t touch my Medicare); the movement shares many aspects of libertarianism but has a long way to go to become a governing philosophy.

But I am sympathetic to the view that government is growing much too large. This opinion is not so much ideological as it is pragmatic or “scientific”, that is, induced from personal experience. The services that government delivers, such as health care and education, are complex, but no more so than operating an airline or an oil company.

Public servants whom I’ve met mean well, but they’re not subject to the cruel discipline of the market place that forces them or their bosses to make hard choices or be out of business completely. Public sector layoffs do happen, but there is no practical possibility that my woe begotten State of California , for example, will declare bankruptcy and restructure the long-term contracts that are the source of much of its fiscal problems.

As government’s role expands from protector (police, fire) to provider, consumers are forced to obtain the goods and services they need by navigating a bureaucracy instead of shopping amongst competitive sellers. Members of our family have spent innumerable hours reading regulations and instructions, filling out forms, and trying to get through to a real person who will answer our questions. It’s frustrating to apply for the medical, education, unemployment, and other financial benefits for which we qualify. Often, we have given up.

[It’s common at this point to level the charge of hypocrisy against smaller-government advocates if they apply for government benefits. Well, these people may have wanted a world with lower taxes and lower spending, but they lost the argument. To me it’s not hypocritical to apply for Social Security benefits when they’ve been paying Social Security taxes for 40+ years or seek unemployment benefits when they and their employers have been paying Federal and State unemployment taxes. After the law is enacted, if a person, regardless of his position in the debate, pays his taxes, he gets to claim benefits.]

I digress. The real purpose of this meandering post was to celebrate the passage of another April 15th. If you think the benefits side of government is confusing, you should see its revenue/tax side. (I’ve written before about my frustration—here’s an example--regarding not the level but the complexity of the tax system.)

This year I had spent long days compiling our 2009 information and got the basic forms mailed by noon on April 15th. It was only in the late afternoon when I remembered a limited liability corporation (LLC) that I had created over a year ago. This LLC is a so-called “disregarded entity” for income tax purposes, but fees and forms still have to be filed. After they cash my check I know these pieces of paper are destined for the giant warehouse that we saw at the end of “Raiders for the Lost Ark.” However, if I ignore the rules it will doubtless be a black mark on my permanent record somewhere. [BTW, a “permanent record” on every citizen was widely believed to exist during the paranoid 50’s and 60’s; it was dismissed as an urban legend in subsequent decades. Who’s crazy now? (:-) ]

But enough caviling. For the past two nights I’ve slept the blissful sleep of the relieved and guiltless. It’s a beautiful Sunday in the neighborhood and 72 degrees F. I’m closing the laptop and going outside. I hope you, dear reader, do the same. © 2010 Stephen Yuen