A healthy debate

Each quarter I receive half a dozen or more proposals from writers for feature articles they’d like to write for Airstream Life magazine.   Usually, these proposals sit in my email Inbox for several weeks, while I do other things.   As I’m conducting the day-to-day business of the magazine, there’s a little part of my brain that is considering the possible use of the article proposals:   Do they fit in the magazine?   How could they be better, or more complete? Can it be part of a theme?

After a few weeks, clarity usually arrives and I write back to the author to tell them whether the article is something we can use.   Many apply; few are chosen.   Mostly this is because I get repeats of the same article suggestions perennially (“my first Airstream experience,”   “my Airstream of Consciousness,” “safety tips,” etc.)   Those are easy to weed out, as are the occasional screwball suggestions.   Those that make the cut will get a detailed and lengthy email from me, outlining specifically what I want, what the article needs to include, style & research tips, a word count guideline, and comments on photography.

But there are a few that really stump me, and I’ve got one such proposal on my desk right now.   The author is someone known to me, a proven writer, and that makes it harder for me to reject his proposal without careful consideration.   He wants to write about medical issues.   Normally I’d toss such a suggestion out with hardly a second thought — Airstream Life is not about such things.   But in this case the author makes an impassioned case for   the need to address the topic of medical care and how an Airstream can be an essential tool when you find yourself supporting a loved one (or yourself) who is spending a lot of time in the hospital.

This recently happened to some friends of mine, an Airstream couple who suddenly discovered that one of them needed some fairly serious surgery. This meant two weeks of diagnostic procedures, consults, and pre-operative examinations — and then the surgery itself, followed by another four days in the hospital.   Where’s a spouse to stay when you need to do all of this at a specialty care center far from home?   The Airstream, parked nearby, provides an ideal solution.

My good friend Bert Gildart also wrote in his blog a couple of years ago about how he parked his Airstream right in the heart of Washington DC at a care facility, to stay near his father when he was dying.   Other friends have used their Airstreams to visit the Mayo Clinic.   It’s done all the time.   What a comfort it must   be to have “home” and family right there outside the doors of the monolithic concrete building where you’re being poked and prodded.

Health is a big topic in my mind right now.   We are all generally fine, but nonetheless we have relocated to Tucson and that means we have all new doctors.   Being new patients, we’ve been subjected to a raft of examinations and tests, and between the three of us, we’ve managed to flunk a few.   My cholesterol is “slightly” elevated.   There’s a slight lump here, an odd mole there, a bit of anemia, etc.   Nobody’s perfect, and of course every little thing needs to be checked out.

Well, don’t worry about us.   We’re fine.   I mention this because it has opened my eyes to yet another element in our nation’s healthcare insurance crisis. Like a lot of small businesses, we’ve been forced by the high cost of health insurance to switch to a high-deductible health plan combined with a Health Spending Account.   In short, we now have a deductible of $3,850 per year, and we have to pay 100% of all our health care costs until we reach that deductible.   The Health Spending Account, financed by company contributions and tax-sheltered, pays the deductible.   This is cheaper overall than the type of coverage we used to have, which paid “first dollar” coverage on nearly every medical expense but cost a lot more each month in premiums.   If you don’t have this sort of plan, pay attention, because you probably will soon.

Having to pay for every doctor visit and prescription means you start to notice what healthcare costs.   That’s a good thing, if you don’t have a heart attack when you see the bill.   Several of our office visits were quoted as costing between $190 and $285.   We braced ourselves, then were pleasantly surprised to find that after the insurance company received the bills, they “repriced” the fees to much lower levels.   The $190 visit became just $70 after the insurance company waved its magic wand.   The $285 visit dropped to $120.   On average, we paid only about 1/3 of what the original bills stated.

This happens because the insurance companies all negotiate preferential rates with the doctors and hospitals.   Anyone covered by their insurance gets the cheaper rates.   Thus, we are discovering that the real value of having health insurance in the short term is not the elimination of financial risk, but the enormous discounts that come with it.   If we’d gone “bare” we’d be facing huge medical bills — and we’re healthy.   No wonder millions of Americans are forced into bankruptcy by their medical expenses.   If you don’t have insurance, you’re going to pay two or three times more than you really should for medical services.

So here I am, a relatively healthy guy with a relatively healthy family.   We try to take care of ourselves in our diet and our activities.   And yet, I am thinking a lot about healthcare these days.   It’s a sign of the times, I think, more than it is a sign that I’m in my mid-forties.   And I wonder: Is this indeed something Airstream Life needs to discuss?

This is why I hesitate to reject the article proposal.   It still sits in my Inbox, awaiting an answer.   The little part of my brain that considers proposals is still spinning, thinking, working on the problem of how to make this kernel of an idea into something that we can publish in the context of Airstream Life.   It feels like a social obligation — to somehow address this critical issue.

You probably never realized that this kind of thought goes into a quarterly travel magazine.   But this is what good editors really do.   It’s not about punctuation and grammar — it’s about feeling what the audience needs and what they are ready for.   Editors are like chefs, mixing up ideas to get just the right result.   Sure, it’s nice to keep your sleeves clean, but in the end you get judged on the flavors of the finished product.

In this case, I’m leaning toward shelving the proposal until we can find an opportunity to work it in logically, perhaps year or two down the road when another topic comes up that would be a good companion. But the internal debate isn’t over yet.   I’ll keep considering a while longer.