September 30, 2008

New York Overheard #1, #2

#1:

A woman outside her apartment building, talking into the mic of her cell phone headset, exasperated: “Look, can’t you understand? I’m just trying to make plans without being wedded to them!”

#2:

An elderly man in a suit, walking with his wife after an event at which she apparently bought a painting: “Do you think that’ll fit into the Prius? I don’t think it’s going to fit in the Prius.”

September 30, 2008

The Sex Tourists

“Sex tourists.”

She had latched onto this phrase, about the men she went out with on dates and she wouldn’t let it go. But Kathy always had problems with men: she was smarter than most of them (brilliant, actually), a sex maniac, and she carried a voluptuous figure, of which she was deeply proud. But this was a terrible combination. It leads to trouble. It leads to heartbreak.

Even if Kathy couldn’t find true romance, she wanted sex, so when she first dabbled in online dating she called it “sport fucking.” But in the end, this was just a way to cover for a string of encounters that had left her sexed up, but otherwise desolate. And lonely. There was something bitter and brittle in her retellings of sport fucking the men she had found – or who had found her – online. One night we were out at a restaurant and she had burst into tears.

A few months later, she was back into the swing of things, dating and complaining.

“I don’t know, David, the whole thing is making me sick. I really don’t care anymore. I’m fine now just doing my work and forgetting about all that other stuff.”

“Me too. I hate women. Women are just not very nice. You’re all not nice.”

“Men suck. They don’t know what the fuck they want.”

“Women are fickle. They’re self-absorbed. They’re contemptuous.”

“I’m just sick of the sex tourists.”

“Women are cunts. Sex tourists?”

“These men I meet, who are just on dating sites looking for sex. Sex tourists. They’re wasting my time.”

“What happened to the sport fucking?”

“I’m looking for a boyfriend!”

“Look,” I said, “I think there’s something wrong with me. Women don’t want to go out with me after the third date.”

I was bitter, too. I had met this great woman. Actress. Substance abuser in AA. Liberal, Upper West Side Jewish upbringing. Obsessed with her cat. Naturally, a fantastic kisser. Really, the perfect woman for me in every way. But she was done with me after three dates, because, she said, I had never been to therapy and my longest relationship had lasted only two years.

“I’m looking for a life partner,” the perfect woman had fretted.

Kathy then told me about her latest disappointment. She said, “I had coffee with this guy last week. You know, we had all these emails back and forth. He seemed great. And so we met for coffee. He has cancer!”

“What?”

“Cancer! What’s he doing going out on dates?”

“He’s got cancer? What kind?”

“I don’t know -– stomach cancer, something. Stage four. Stage fucking four cancer.”

“Oh man, so he’s going to die.”

“Probably, I don’t know. I don’t have time for this shit. This sex tourism shit.”

She sounded at the end of her rope.

“Kathy, you’re insane. That poor fuck is a sex tourist?”

“I can’t help him. He can’t have a relationship now. Why is he meeting me for coffee?”

“I don’t know, maybe he just wants to meet a nice girl. Women really are evil,” I said, angrily. “You’re all evil.”

Kathy was silent for a moment.

“It’s just,” she said quietly, “it’s just all these sex tourists.…”

September 18, 2008

It’s the End of the World! Financial Collapse is Nigh!

We were chatting in the café area of the place where I rent space with other writers. The topic was the financial crisis hitting the investment firms here in New York. We nervously discussed the looming economic apocalypse. I worried that maybe I shouldn’t buy that house in Vermont right now, considering I’m unemployed and about to pay $10,000 for surgery in a town near Fargo, which I only know through the movies as a wintry tundra. Meanwhile, Lehman Brothers is declaring bankruptcy; Bank of America is buying Merrill Lynch; the government is seizing control of AIG; Morgan Stanley is looking for a buyer, possibly the Chinese.

Ron wasn’t too worried. He retired at 30, after selling his technology startup.

“If you sold your apartment, you could live off the interest.”

“Not on $14,000 a year. Plus, where would I live?”

“Move to that house in Vermont you’re buying.”

“Why am I doing this?” I wailed.

I man walked into the lounge, heading for the bathroom. I’d never seen him before, but he knew Ron. He stopped and looked at us.

“500.”

“What?”

“Market’s down 500 points.”

“It’s a bloodbath,” sighed Ron, languorously. Then, “David, this is Sol.”

We shook hands like men who were about to head off into battle together. Sol wore an excited, agitated look on his face.

“This is going to be worse than the Depression,” he said. “I mean, these investment firms, these giant investment firms – they’re broke! They’ve lost all their money!”

“Lehman’s got 25,000 people,” said Ron.

I’m losing lots of money in the stock market,” I said, looking for reassurance.

“The bottom’s completely fallen out. And it’s just started.” Sol was sweating, waving his arms. “It’s going to get worse. A lot worse. Just watch. They’re not the only ones going down. Citibank. WaMu.” He shook his finger at us. “New York’s fucked.”

“Services are going to get hit,” said Ron, the boy from Vermont. He had never experienced New York during its dark days. The crime, the graffiti, the rot.

“Are you kidding me?” exclaimed Sol. “It’s going to be like the 70s again.”

I sat down. I could feel my heart beating. This was very bad timing.

“I should sell my apartment while I still can,” I said. “And get a job. Do something.”

There were other people in the suddenly quiet lounge and they were paying attention now, watching Sol’s mad performance. He sounded like an expert, but nobody really knew. I was afraid to ask.

“You really think it’s going to get worse?”

“Oh, sure,” Sol said, spreading his arms. “There’s no liquidity! No one’s giving out any money.”

People had moved closer, expressions of worry clouding their faces.

Someone asked, “I’ve been looking to buy an apartment. Bad idea?”

Sol, the randomly anointed economic soothsayer, looked at him with disdain.

“Are you fucking out of your mind?”

September 11, 2008

How to Negotiate the Cost of a Surgery and Still Pay Almost $10K

“You have a couple of options,” said the surgeon, Dr. Mitchum. We talked over the phone: he in Minnesota, me in Germany. “It depends on your tolerance for risk. We can do a partial takedown. That’s easy enough. Or we can try to fix the wrap.”

The wrap was the fundoplication surgery I had received 14 months earlier.

“That would entail a complete takedown, right?”

I sat at my aunt’s dining table, one hand clutching my forehead. Tante Edelgarde was already in bed; the rest of the house was dark. It was 11:30 at night. The village was dead quiet. In mid-afternoon Minnesota, the surgeon’s voice had the brightness of daytime.

“Right, and it would put your vagus nerve at risk. The posterior stitches are harder to get at; I’ll be digging around back there and so there’s a danger I’ll nick the nerve. I’m not saying I can’t do it. It’s just that you need to know the danger.”

“My current surgeon told me that my vagus nerve is stressed from the first surgery and that’s why I’m getting the bloating and gas.”

“In my experience the vagus nerve is either working fine or broken. There’s no in between. And your gastric empyting test was fine, you said.”

“Right.”

“If we just remove the anterior stitches — which is easy enough — it should relieve the pressure.”

“And then I’m back to heartburn.”

“You still might get some therapeutic benefit from the wrap at 90 degrees.”

“Look, I’m interested. It’s a little crazy, though, that I would fly all the way to Minnesota for surgery.”

“Well, we’re in a nice little town.”

“Oh yeah?”

“Yep, if you’ve ever seen that Coen brothers movie, it’s near Fargo.”

“Really?”

“Pretty accurate about the winters.”

“So it’s not close to Minneapolis?”

“Oh no, in fact you layover in Minneapolis and then you take one of those little regional prop jets over to Brainerd.”

“Oh, God.”

“We’re about 15 minutes by car from Brainerd.”

“Of course, this is way outside my network. I’m going to have to pay out of pocket. What’s this all going to cost?”

“Let me tell you, this is what you do. You need to negotiate. There’s my fee and the hospital’s fee. I’ll tell Sally to find out what my fee is — I don’t even know, it depends on the codes — and what the hospital’s part is going to cost and then you have to negotiate. Negotiate my fee, too. Tell them that you’ll be paying cash, up front.”

“Christ. It’s like I’m buying a car.”

“I know. Health care has become like a commodity.”

Minnesotans are slow. It took two weeks to get an estimated cost for Dr. Mitchum’s fee. $3,300.

“That’s with a discount,” said Sally, the surgery aide.

It didn’t seem too bad. I had expected worse. So I didn’t try to negotiate it down. Meanwhile, the hospital took another week to come up with their price. When they did, Sally called me again.

“Ok David, well first, we had the surgeon’s fee wrong.”

“Oh no.”

“It’s actually going to be $2,800.”

“Really?”

“Yes, it’s gone down.”

“Does that ever happen?” Dr. Mitchum might have taken pity on me.

“I don’t know. Now, we heard from the hospital.”

“Yes.”

I heard Sally take a breath. A deep one.

“Their fee for the surgery is, um, $14,000.”

“What? You’re kidding me! Really? That much?”

“Yes, but with the regular discount they give private patients it comes down by 35%, and if you pay the whole thing at one time, they take another 20% off. That will bring it down to about $8,000.”

“That’s still a lot of money, Sally.”

“I know. It is.”

“Is there anybody I can call over there? Dr. Mitchum told me to negotiate.”

Sally gave me a name and a number of a man known as Karl. So I called Karl.

“You see, these are standard discounts we give uninsured patients,” Karl said. “It’s mandated by law. We have contractual obligations. There’s the 35% discount; it’s what we give our preferred insurance carriers. And then if you pay up front, another 25%.”

“And you can’t do any better than that? I will pay you in cash up front. No waiting for the insurance company to pay you — you’ll get the float. And no paperwork. That’s a tangible benefit.”

“No, it’s all regulated. If we gave you a bigger discount, it would would mean we were breaking the law.” Karl chuckled; even he didn’t believe what he had just said.

“I don’t know.”

“Look, that quoted cost is just an estimate. And it’s a high one. The amount is based on time — how long a procedure takes. I looked in our files for the last time we did this and that’s how I came up with the number.”

“Was that for a full or a partial takedown?”

“Full takedown.”

“Ah, see I’m going to get a partial takedown. Would it be possible for you to talk to Dr. Mitchum to see how long that would take and then come back to me with a new estimate?”

“Sure, I can do that.”

“Because I really want to get this thing done,” I said. “And at your hospital, because I respect Dr. Mitchum and the work you do there. I don’t want to have to take this surgery somewhere else. And I want to get this done as soon as possible.”

“Well, now’s the time, David, before the winter comes. We have rough winters.” He laughed quietly. “Rough winters.”

Another week went by until Karl and I talked again.

“David,” he began, “I can offer you a new price, in which you’ll pay the hospital no more than $5,600. That’s the best we can do.”

I thought about it for a moment; I wondered again if the hand of Dr. Mitchum had intervened on my behalf.

OK, Karl, let’s do it. So what are my next steps?”

“Call Dr. Mitchum’s office and schedule the surgery.”

“And If I’m lucky I can get it done this month.”

“It would be the perfect time. You want to do it before winter sets in.”

“Karl, it already has.”