April 15, 2020

And just like that, it’s April 15th. In an ordinary year, people would be pounding their heads into their laptops trying to make TurboTax spit out comprehensible numbers and a refund. This is not an ordinary year, however, and taxes aren’t due to July. I actually had everything complete and to my accountant in early February this year, figuring that a late March or early April refund would help fill my coffers for moving expenses. More fool I. I called my accountant late last week and he, like every other CPA is snowed under with stimulus program havoc. Routine tax returns will just have to wait. He’s done my taxes since I moved here during the last millennium so I trust him to do what he knows how to do.

The great shut down of 2020 is, of course, playing financial havoc in more ways than just accountants trying to figure out the byzantine rules of hastily passed small business loan assistance programs. And, as money makes the world go round, the lack of it flowing through the system as everyone retrenches for a more sedentary and less consumerist life, is shaking the powers that be. Conservative ‘grass roots’ protests against shut downs and social distancing are sprouting up. The most visible one today was in Michigan at the state capital in Lansing. Of course what most of the media reports are leaving out is that these are orchestrated by the usual big money conservative families with an agenda – the Lansing rally was paid for by groups tied to the DeVos family of Amway and Secretary of Education fame. i don’t think there’s been much protest on the right wing in decades that hasn’t been paid for by some deep pocket. There are, of course, some economic winners in all of this. The Ravensburger jigsaw puzzle company is having it’s best year in all 138 years of its existence. If you can’t find a jigsaw and are close to me, I have a few I’m willing to give away as I downsize.

The numbers of cases keep going up. There’s some interesting social epidemiological trends happening with fifty states responding in fifty different ways due to a lack of organized central leadership. The one I was most interested in today was South Dakota, a relatively small state population wise, where cases have increased nearly ten fold over the last ten days from about 100 to nearly 1,000. The culprit? The conservative governor’s steadfast refusal to employ any social distancing or shut down orders of any kind. I imagine we’ve only seen the tip of the iceberg there. The pattern will be similar in a lot of rural America. A population that have been fed a diet of misinformation about how it’s a coastal city problem, or no worse than the flu, a hollowing out of health infrastructure through politics and neglect, a hollowing out of community life through the destruction of small agriculture and manufacturing, and the great equalizer – the one large institution where everyone in town meets together day after day. Wal-Mart – the only place left to shop. And we won’t hear about most of the deaths in small town and rural America as it’s outside the ken of most media figures and therefore not really real to them or worthy of much interest.
Tonight’s subject seems to be money. There’s an odd thing going on which at first seems counterintuitive but, on closer examination, makes perfect sense given that we’re operating in a health care industry and not in a health care system. Just at the time that doctors, nurses and other health care workers are being called upon to put themselves in harms way and sacrifice much, including possibly their lives, for the good of American society, they are being faced with pay cuts of 10, 20 and I have even heard some reports of 50%. Why on the one hand are they being lauded as heroes and on the other hand being punished? It’s because health care is big business and it’s a for profit business in most of the sector. Covid 19 is keeping people with other illnesses away from the health care system as they start to realize that whatever is going on with them is not so serious as to risk exposure in a crowded emergency room or urgent care clinic. Visits are plummeting. Doctors are wisely keeping those with chronic illnesses out of hospitals and large clinic buildings where sick people congregate. Outpatient volumes are down 50-75% nationwide and hospital bed occupancy is also way down – to free up more front line staff for Covid cases, and to keep ill people away from active cases as much as possible. Those who are coming in with Covid are, of course, sicker than snot but the numbers are small compared to the numbers of patients that usually show up over the course of the average workday. Without elective surgeries, lab tests, routine check ups and monitoring of diabetes, hypertension, administering of chemo and all the thousand and one other things that happen every day in usual volume, collections are way, way down. If a business isn’t bringing any money in, expenses have to be trimmed. I’m not personally alarmed as I’m a pretty cheap date and I work in a specialty where we all support each other and are socialistic about such things as compensation. It’s going to be different for the young ‘uns, who gave up their youth and put themselves in a huge amount of debt to complete their educations and now won’t be able to manage the loan payments, the mortgage and the kids college fund. The days of the rich doctor were over before I ever entered the profession and primary care and cognitive specialties have never paid terribly well and have had a terrible time recruiting students over the last few decades. That’s going to become harder than ever and I think a number of mid career physicians, when this dies down, are going to look at these trends and get out and do something else with their lives. I’ll keep at what I’m doing. Too old to change.


Speaking of money, as of today I have two mortgages, at least until I sell the house. I am now the proud owner of the new condo as of 2 PM this afternoon. The next couple of weeks will be spent getting it ready for move in and then I’ll figure out some way to actually execute a move in a time of social distancing and corona virus. I’d consider taking some pictures and posting them but it’s all a rather dreary off white color scheme and I think I’ll wait until I get it painted. I don’t think I’m going to go quite for the wild palette Tommy used in the old house, but it’s going to have color and reflect my rather eccentric personality. My favorite type of style is Regency/Empire but, of course, I don’t have much in the way of furniture that actually fits that. Someday. And I can’t go too far that direction in a mid-90s condo block. It would look a bit silly.

I had another topic I was going to tackle tonight, but it’s late and I need to get some sleep before solving the problems of Walker County veterans tomorrow. I’ll take it on in a later entry in the accidental plague diaries.

Be well, be safe, and wash your hands.

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