Right-wing talk show host Rush Limbaugh was recently hospitalized in Hawaii. He made this statement upon his discharge:

The treatment I received here was the best that the world has to offer, based on what happened here to me, I don’t think there’s one thing wrong with the American health care system. It is working just fine, just dandy.

It stands to reason that someone rich enough to afford a $10,000 a night condo in Hawaii is going to get great healthcare. Not surprisingly, Rush was ignorant of the fact that he experienced same medical treatment any state resident (or visitor) would receive. 

More on Hawaii in a moment. Rush’s “fine and dandy” hospital treatment reminded me of another surprising source of decent health care I learned about at the end of last summer. It came out of a conversation with Bob - not his real name - at the Albuquerque airport on my way home from Santa Fe. He sat down next to me at the airport bar and began to chat me up. We talked about preseason football, the incredible ( the best I’ve ever had) Santa Fe Indian Pale Ale we were drinking, and the prospects for the San Francisco Giants making the playoffs.

He mentioned that his union hall was located directly across from the stadium. "Which one?" I asked.  He proudly said, "The California Correctional Peace Officers Association, I work on death row at San Quentin." Unsuccessfully trying to hold back what was struggling to get out of my mouth, I blurted out what he must have heard a thousand times, "Wow that must be a horrible job." Reflexively, he  responded , "No, I  really love my job!" 

Continuing to loose the battle with verbal impulsivity, I asked Bob if loving his job had anything to do with his view of the death penalty. "No, I still don't know where I stand on the death penalty, I struggle with it,  but my job is great because I have seniority.  That means that I often escort the inmates when they have to travel. I travel mostly for medical reasons and occasionally for court when their appeals are active and in process."

He told me that inmates on death row get "pretty good" health care. “Our unit is the largest death row in the nation, 697 inmates. In such a large, aging population it's inevitable that someone will need some type of sophisticated medical intervention, sometime." He went on to tell me about trips to the Mayo Clinic, Stanford University, hospitals in Los angeles, and a wide variety of other upscale healthcare institutions nationwide. 

"Are you telling me that murderers scheduled for execution have access to the best healthcare in the world?" I asked incredulously.

"Just the United States,” he smiled. “ Our own healthcare center at the prison is pretty rundown. Like death row, it was scheduled for a complete renovation but then the California deficit got in the way.  Actually, some suggested that the entire prison be sold for 2 billion dollars. Must be because it's waterfront property in Marin County," he laughed. 

The courts have established (and continue to consider) that prisoners have a right to medical treatment. Like Rush, the majority of death row inmates will die of natural causes. Unlike the vast majority of the Western World, however, Americans are not entitled to the healthcare that Murderers, stupid talk show host making 38 million dollars a year, and most Hawaiians enjoy.  

Sorry, Hawaiians, I didn’t mean to group you with murderers and I know that you have a great healthcare system. Hawaii has required all employers to provide relatively generous health care benefits to any employee who works 20 hours a week or more since 1974. Consequently, Hawaii residents live longer than people in the rest of the country. Moreover, Hawaii’s health insurance premiums are nearly tied with North Dakota for the lowest in the country and Medicare costs, per beneficiary, are the nation’s lowest. Significantly, the most expensive component of any healthcare system, emergency room visits, are 34 percent lower than the national average - a huge money saver. 

Even though it has worked since 1974, Hawaii’s approach isn’t perfect. Employers have to bear costs not shared by their competitors on the US mainland. Obviously, that wouldn’t be an issue with universal coverage. The current bill before Congress doesn’t come close to matching the Hawaiian mandate. And it’s not likely that a system as comprehensive as Hawaii’s could receive anything near the necessary majority to become law. 

While on its surface, David Letterman's joke about rats getting free healthcare is hilarious, just below the surface resides a profound and heartbreaking irony. In fact, Anthem / Wellpoint  just announced a 39% increase for insured individuals in California. Kind of makes you want to commit murder, doesn't it?

If you can’t move to Hawaii - jobs are scarce - or end up on California's death row - actually, harder than you think - what do you do? I'm going to write more on this later when we know the final status of the health care bill before congress. More importantly, I'm interested in what you think. Please, please leave a comment. Thanks!

Charlie Johnson

Otherwise, I laughed my ass off.  I’m talking about Vox Phamalia: Redux, an onstage review presented by Phamaly,  a group of remarkably gifted actors who are also disabled. The performance has been depicted as “edgy,” but I think this description significantly under-represents the impact of experiencing it in person. 

For me, it began when my friend, director-playwright Edith Weiss asked if I would be interested in being a volunteer stagehand in the collaborative effort she and a group of disabled actors were going to put up in the beginning of November.

Phamaly is a 20-year-old theatrical organization presenting well-known plays and musicals entirely utilizing the talents of disabled actors. Before you think that this is some kind  of “Special Olympics” for actors, you should know that Phamaly produces big popular shows at well known venues that are attended by knowledgeable theatergoers. The reason that their productions receive consistently good reviews is that these people can act, I mean really act!

This production represented a major departure from the group’s more typically commercial efforts.  It originated out of a 12 week workshop Edith conducted with about 10 actors with the goal of theatrically representing their (very personal) everyday experience of living with a disability. The result is a completely original, laugh-out-loud, profoundly politically incorrect sketch show written by Edith and the actors.

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Why base a book, podcast and blog on a novel written 300 years ago about an adventurer abandoned on a deserted island who ultimately  transformed his experience from barely surviving to abundantly thriving. Please forgive me for asking a question that attempts to answer itself.

In writing our book about a psychological approach to illness, Recrafting a Life, Denny Webster and I thought that this fictional character’s experiences and masterful solutions to a seemingly hopeless situation would be a great metaphor for individuals suffering from serious health problems.