Health Insurance and Medical Bills

I had a fairly urgent outpatient surgery done on me a few weeks ago. A quick trip to my GP verified that I needed the procedure and he scheduled a meeting with the surgeon for the next afternoon. A week later I showed up at the hospital shortly before seven in the morning and I was sitting in this chair typing on my blog and eating an early lunch by 11:30. No complications and knock on wood so far it's been a very easy recovery which I am now half way through. My care was very good and all the services rendered were timely and professional.

Melissa, Carter and I have a fairly comprehensive medical policy through Blue Cross. Being self employed, we pay the whole shot...no break for us We have pretty high deductibles and the deductible is 3X higher for our "family" than it is for either of us, but I'm not going to complain about that right now. We walked into our health insurance policy with our eyes wide open and there are legions of cheaper if less comprehensive options out there.

What I *AM* going to complain about is the tiered billing system that seems to be normative in American health care. We got our hospital portion of the bill today.  Combine that with my surgeon's bill and the anasthesia bill and my little surgery looks mind bogglingly expensive. And so it would be if I was uninsured and had to pay for it out of my pocket which is why I have health insurance in the first place. But what I would have to pay if I didn't have insurance isn't anything like what my insurance company actually pays and thanks to the explanation of benefits they are required to provide I get to see this. Think 20-25 % of the actual "bill" between my deductible and the insurance company's portion and you'd be in the ballpark.

Can you name another service where the difference between the negotiated price for a large entity and the price for a guy off the street who wants to pay in cash is a 75 to 80 %  reduction in favour of the large entity? If I walked in to a feed store or a fertilizer depot and asked for a 75 % discount  I would get laughed out of the store and our customers would be up in arms if we tried it with them...rightly so. In my opinion whatever the price of my surgery is it ought to be pretty well the same regardless of who pays the bill. I understand that a portion of society won't or can't pay their bill and I understand that collecting the money or writing it off needs to be built into the cost. That's standard business procedure. But charging an individual four times what an insurance company pays is not standard business procedure in any other industry I can think of. If what the insurance company pays is actually reflective of the charge then the public is getting hosed in a very, very large way. Frankly if I knew I could pay what the insurance company pays I would probably change my policy from comprehensive to catastrophic and pay the difference out of my pocket. In this writer's opinion addressing this issue would go a very long way to making health care and health insurance a whole lot more affordable for everyone, insured or not.

Getting off my soapbox now. :)

His Name is X

[ I wrote this post nearly a year ago, just before our first trip to Russia to meet our son. He's asleep in his room as I write this addendum and we couldn't be prouder or more pleased with how our story has turned out. ]

His name is "X", and we don't know very much about him at all. We don't even know what he currently looks like which is odd given that in a few weeks we're going to Russia to begin the process of making him our son. I can't speak for Melissa but I have the butterflies a hundred times worse than I've ever had them before in my life. And I've got questions running through my mind all day every day. Will he like us when we meet him ? Will he like his life here with us ? What does his life look like now ? Am I fit to be a parent ? What is Russia like ? What's being an orphan like ? Each day that goes by, the questions intensify. Those of you who are or were first time parents get the idea, I'm sure.

Right now, child X remains one of 750,000 unclaimed and abandoned Russian orphans. He's lucky compared to some because he hangs his hat and bib in a relatively well endowed Moscow baby home. In spite of his current circumstances I think it's fair to say that he'd have no chance if he wasn't adopted. Most children aren't adopted because most Russians view orphan kids as broken and unfixable. The system ensures this perception remains accurate because the kids are kicked out of the orphanage system when they are sixteen and statistics say that forty percent will die or be in prison within two years. How sad is that ? How bad must your own circumstances as a parent be that you would voluntarily give up your child to an institution to raise knowing the probable outcome and thinking that they would still do a better job than you will ?

For me, the worst part of this process is that although this is one of the biggest moments of my life I can't share it with anyone because it's not a sure thing yet. There is still some niggling chance that a Russian family could claim this child ahead of us. I know some of you reading this are saying to yourselves, well if not him then you're going to bring home another, so what's the fuss ? I guess that's right to a degree, but if it's possible to love someone you have never met then child X is already loved. And claimed. And wanted, too, very much so, as every child should be. We have thought about him and talked about him every day since we got our referral.

As much as we can make it so, this child's life here ought to be a good one. We've built our farm and our business around the idea of raising a family in a nurturing, safe and supportive environment with his mom and dad both available to him at a moment's notice and with at least one set of grandparents close by. We debated adoption for a long while. In the end, I wonder why we debated the concept for so long when every critter in our large menagerie is adopted. What could be better than sharing the wholesome farming life we've created with a needy, unwanted and unloved child ? At this point, I can't wait to find out.

I Hate Farm Equipment

I have a publication called Amazing Farm Inventions lying open before me on my kitchen table right now. The theme of this month's magazine is, " Made it Myself; Ideas Born in Farm Shops". Some of the ideas are pretty off the wall and some are pretty impressive. Clearly the folks who did this obviously like working on equipment  in their shops AND they have enough spare time and brain power to think their way through some seriously complex projects. 

I find both of these things extremely impressive because I operate at a much more fundamental level than this when it comes to farm equipment. When I jump on a tractor seat early in the morning what I really, really want it to do is start and run for as long as necessary with no problems or interruptions along the way. Then I want to shut it off, go to the house and forget about it  until I need to use it again. When my baler isn't tying properly or the middle row unit on my corn planter inexplicably seizes up and refuses to drop seed or I manage to put a rock through the feeder house and sieves on my combine I tend to get angry and frustrated rather than creative. The same thing happens when tires go flat, batteries go dead, pto shafts fly apart or any of the other maladies that plague farm equipment occur on a somewhat regular basis. It's not that I can't fix most of the stuff when it breaks. It's that I get no joy whatever out of the process, especially when everything here is serviced on time and put away ready to go.

Gramps used to say that machines didn't break when they were parked in the shed. I agree but I will take that a step farther and say that machines don't break if you don't own them at all, either. If I could figure out a way to cost effectively custom hire every bit of machinery work done on my place I would happily do so. I'm not one of these guys who farms because I have an iron fetish.  Given that a lot of my full time farming neighbours are hiring more and more of their time sensitive machine work done I don't think I'm alone in thinking this way, either.

Don't even get me started on equipment that is so poorly engineered that it's difficult or impossible to service, adjust or fix without dismantling it. If folks like me who buy equipment have to contort ourselves into pretzel-like shapes to change a fuel filter or check the oil it probably isn't going to become one of our favourite tasks. When it comes time to replace it, we will probably be looking at a different brand. Speaking of fuel filters, why is it that none of the tractors I own have an easily accessible fuel shut off valve located on the line somewhere above the filter ? It's easier to soak my arm in diesel fuel every time I change a fuel filter than it is to find and turn the fuel shut off valves on both tractors at this farm. But I digress.

Truthfully, I can't really imagine what it would be like to farm with no equipment whatsoever. Four wheel drive tractors, front end loaders, round balers, bush hogs, manure spreaders, air compressors and innumerable other pieces of equipment make my life tremendously easier than it would be without them, especially when they run right. And when they don't believe me when I say I can turn the air blue with the best of them.

Resuming...

When I was in my fourth year of high school I served as the President of the Student's Council. One day I was sitting at our kitchen table preparing a speech to give to the student body at an assembly the following day. I always stood and read my speeches out loud before I gave them and my audience that night was, as usual my mom and dad.  When I got done I asked what they thought. Mom hemmed and hawed but dad cut right to the chase. He pulled me aside after mom left and said, " Son your speech was good in terms of grammar and syntax, but you're not smart enough yet to be that long winded." Although it took the wind out of my sails a bit at the time he was exactly right back then and twenty odd years later he is still right. When compared to giving speeches the great thing about blogging is that you don't have to be very smart to offer up long winded posts on topics you really have no business writing about. You just have to keep at it. After a long pause to deal with all that life was throwing at me it looks like I'm back, at least for the moment.

As all of you who read our Paradigm Farms blog already know, we lost Melissa's dad to cancer early last week. Melissa did an excellent and unimproveable job of writing a very moving tribute to her dad and I probably ought to let that topic rest. However, before I do I have one story I'd like to share with you here.

For a whole variety of reasons, we decided it would be best to send Melissa and her mother to Moscow on our third and final trip to bring home our new son Carter. During the week they were away her dad and I spent a lot of time together and he became more and more restless as the week wore on. Melissa, her mother and Carter were due on a late evening flight from New York the day they were to arrive home so I was somewhat surprised to find Tom sitting wide awake outside in his chair with every light in the house and garage on at 4:32 am when I left to start morning chores. He waved at me on the way by to let me know everything was okay....well, more or less okay anyway. I got through with my work and came home about four and a half hours before their flight was due. I stepped out of the shower and much to my surprise I found Tom waiting in my driveway ready to go get supper and get on to the airport. Supper took about fifteen minutes and the drive to the airport killed another three quarters of an hour. Tom spent much of the remaining time pacing the large mostly empty waiting area with a half full cup of cold coffee and telling everyone in the room that he was waiting with me for his daughter, wife and new grandson to get off the plane. When the plane finally landed and folks started appearing at the gate he was so worked up that the TSA agent working the control point had to ask him to back up several times. He was instantly smitten with Carter, but in truth he was no more smitten than he was with any of the rest of his grandkids. It just felt that way. I lost my dad more than fifteen years ago and in a lot of ways Tom became something of a surrogate parent to me. I will miss his presence very, very much.

Foreign Possibilities

It really is a strange old world we live in sometimes. While Melissa and I waited to board our Delta flight to New York a few months ago at Sheremetyevo Airport in Moscow I spotted a tall youngish guy in a check shirt and jeans who wore the permanent tan of someone who spends their life outside in the sun in every kind of weather. He was also wearing a baseball cap that advertised a cattle breeding farm in Nebraska. As I checked him out so too he checked me out. When our mutual appraisal was over he gave me a small smile and a short head nod both of which I returned. I thought that was it until after I sat down; the big farmer was sitting directly across the aisle from me.

With ten hours to kill and another farmer close by you can believe we did some talking as the plane crossed the Atlantic. Turns out this guy grew up in Nebraska but was currently the manager for a big 6000 head/30,000 acre Angus breeding farm in Kaluga, Russia a couple of hours south of Moscow. The Russian/American partnership/farm imported all it's genetics from the US and was in the process of setting up a total farm to plate system including a packinghouse and a small feedyard to finish the animals on corn silage. I quizzed him pretty good on climate, soil conditions and local available agricultural infrastructure and as near as I can tell that area of Russia has a climate and soil conditions similar to those found in southwestern Minnesota. The only odd part was that despite vast native grassland resources and a suitable climate for raising huge herds of beef there is no real native beef industry in Russia. I can attest to the extremely high prices of beef at the grocery stores I visited in Moscow and it blew me away that most of the beef I saw was imported from Australia. Russia is a pretty volatile place economically and otherwise but putting two and two together I think this may well be a heck of an opportunity for those who get in on the ground floor. It certainly managed to get the wheels spinning in my head !

Ours really is a world of possibilities. I've heard all my life about the underutilized but extremely fertile chernozem soils found in a broad belt from the Ukraine across southern Russia and into Siberia. What I heard from my farmer friend confirmed much of what I had heard through second hand sources before. If managed properly this region has the potential to become a huge player on the world stage in terms of agricultural production. Maybe one day between now and then I'll get to go back and actually see it with my own eyes !

First Bloom Dates

If any of my blog followers want to play along with me I am quite interested in knowing when various measures of spring arrive at your house. My dates for Lynnville, TN are in parentheses.

On what date did you notice the first forsythia blooming ? (Feb 2)

How about the first lilac in bloom ? (Mar 3)

How about Daffodils ? (Feb 2)

When did you first mow your grass ? (Mar 1) How long was it at that time ? (cool season 6-12")

How about last frost ?

For the farmers in the audience, when did you start hauling manure (Feb 29)? Seeding small grains or pasture (Mar 2) ? Planting field corn (don't do this any more but noticed corn planters rolling Mar 21)?

If enough of you play along (and feel comfortable sharing your approximate location...southern Vermont, eastern Ontario, Toronto, Ottawa, etc.) this could be fun. Feel free to share any other spring-type information too !

Organic or Not

According to Wikipedia, "Organic foods are produced using methods that do not involve modern synthetic inputs such as synthetic pesticides and chemical fertilizers, do not contain genetically modified organisms, and are not processed using irradiation, industrial solvents, or chemical food additives."

Fair enough.

I'm going to start this post by saying that I have no bones to pick with organic producers or honestly any producers as long as they operate their farms with integrity. The problems start when producers, marketers and regulators say or allude to doing one thing and then go and do something else entirely. This is equally true in both conventional and organic agriculture. Even more problems accrue when organic producers try to use industrial production methods to ramp up scale. That's like trying to fit a square peg in a round hole. Type "organic feedlot" into your favourite search engine and see what comes up. I think you'll be surprised.

If you can't use synthetic pesticides to control weeds and insects and you can't use commercial fertilizer to replace the nutrients that are harvested and removed from your soil along with your crops then one has to modify production methods in order to achieve reasonable production and pest control while maintaining soil and animal health. Long (7 year +) crop rotations with small areas under cultivation and with most of the acreage in well managed pasture under a system of rotational grazing will go a long way to making organic production methods work as they ought to do. Lots of forages combined with lots of animal manure applied appropriately will build soil fertility and minimize pests. Animals that live in uncrowded conditions and that are moved to fresh ground every day or two will have minimal problems with pests and diseases.

The gold standard mentioned above feels sometimes like it's almost impossible to achieve. And if you're trying to go organic and you deviate very much from it I promise you'll get bit in the rear sooner or later. Sometimes you'll get bit in the rear anyway, just for fun.

In spite of what you may believe sometimes there isn't much difference between organic and conventional production methods, either. I'll highlight my points with an example.

Sweet corn producers have battled European Corn Borer (ECB) for a long time. Long rotations help control this pest and most producers, both conventional and organic, practice long rotations. Organic producers also sometimes plant a refuge....another crop that's more attractive to corn borer than sweet corn. But if ECB really comes on like it does in some years none of this will be enough to save your crop and other methods will be called for.

Here are some of the things you can do to control ECB infestations.

1. Grow GMO sweet corn that has bacillus thuringenesis (Bt) genes already in it to combat European corn borer ?

2. Grow conventional non GMO sweet corn and spray it with Furadan or other insecticides multiple times to control European Corn Borer ?

3. Grow organic non GMO sweet corn and dust it with Bt powder several times during the growing season.

As near as I can tell, option three is/was in compliance with at least some organic certification programs.


No matter their stripe, farmers face a myriad of unexpected problems and even the best farmer gets caught with his pants down periodically thanks in no small part to to the fickleness of nature and animal life generally. There is more than a little truth to the statement that anyone aspiring to start an organic farm ought to probably spend some time learning to run a conventional farm first so that when the inevitable challenges come there may be a fail safe in place instead of instant financial ruination. I've farmed my entire adult life and it still surprises me how quickly animals can get sick and how vigorously weeds can grow.

In some ways our farm would qualify for organic certification, especially on the cattle side, but in spite of the possible economic benefits I've never bothered to try to achieve it and I doubt I ever will. While I don't love using them, sometimes a few dollars worth of fairly benign pesticide will do a lot less damage and provide better results than will any certified organic procedure. Likewise, sometimes judicious use of vaccines and antibiotics will save a valuable animal and/or prevent a devastating disease outbreak before it has a chance to run amok. While I think there is much to learn from well run organic farms, I don't like some of the constraints that come with organic certification.