Affordable
Christine waggled the wooden pencil between her index and middle fingers. The rubber eraser tapped, shuddered to silence, tapped again. She scooped a few strands of her dark pageboy behind an ear and studied the candy-colored rows of numbers crawling off her computer monitors. The eraser tapped faster, faster, then rattled to silence. She leaned back, pulled off her computer glasses and let her gaze relax on the photograph on the far wall: Ansel Adams’ monumental Moon and Half Dome. Fluorescent lights reflected off the glass, obscuring part of the rock.
As Acme Health Care’s vice president for productivity, her mission was to reduce operational costs. The most visible efforts, the ones that were broadcast company-wide, exhorted employees to streamline their processes by assembling a task force to flow chart the work and identify opportunities to save steps, resources, time and money. It worked, really it did, and if it didn’t, at least everyone understood the problem once it had been dissected.
This project, though, was a special assignment for her and her alone. The CEO, George Burnett, had sprung it on her a few weeks ago during their weekly one-on-one meeting.
He’d crossed his arms behind his head and leaned back, way back, in his executive chair. As the chair popped, Christine wondered yet again if he’d lean too far and lose his balance. His position, accompanied by an extravagant study of the hanging-tile ceiling, was his usual prelude to tough questions such as how to toe a legal line while wrenching out higher profits.
George popped upright and fixed her with blue eyes that could charm or command. “Christine, as you know, we’ve been fighting a losing battle for profits for some time now.” She peeled apart her lips to argue—the profits were entirely respectable—but he stopped her with his palm. “You know what I mean. It’s like we’re standing on the beach and the tide washes round our ankles and takes a little more of the sand with every pass.” She had heard this before.
“But if you look at the numbers . . .”
“The numbers show us holding our own, and that’s not good enough.” He pushed to his feet. “The baby boomers are building into a tsunami on our whole health care system. It will ruin us. Not tomorrow, maybe, but soon, and I don’t think we’ll be able to run far enough to survive.”
Burnett unbuttoned his cuffs and rolled up his sleeves. “As you well know, we’ve studied this sixteen ways from Sunday with every kind of group we could assemble.” Indeed she did; she’d been on many a task force.
“If we keep looking at it the same way, we’re going to keep getting the same answers. What we need is a fresh take, unfettered by a team setting. I want you to think so far outside the box that you can barely even see the box. No taboos, no sacred cows. How can we get this done.”
She twisted a pearl earring. “You know the kinds of issues we always butt up against . . .”
“I do,” he said flatly. “Personal bias, public relations worries, fear.” Hands in pockets, he walked to the window and peered through the venetian blinds to the hundreds of windshields glinting in the parking lot. “I have an elderly father. I know how hard this is.”
She considered him anew, as a son, not as a CEO. She’d heard him talk about his teenagers, but not his parents. Her own father took up more of her time and brain space than she’d prefer. “You see him often, then?”
“Not as often as I’d like, but at least once a month, no matter how busy I am,” he said with the sort of grim determination used to schedule a colonoscopy.
And his wife and money probably cover the rest, thought Christine. Whereas I, unmarried and without siblings, am my father’s favorite dinner companion, unpaid accountant and health care interpreter.
Burnett turned from the window. “Ordinarily I’d give this assignment to Franklin, but truth be told, I’m kind of glad for an excuse to let you spread your wings.” Franklin Yale, vice president for new initiatives, was in his late fifties, worked almost as hard as she did and maintained all the right connections, to boot. She had long felt that she couldn’t compete with him; he was the total package, whereas she was a great runner up. Currently, however, he was recovering from a series of strokes. He’d be back to work in a few weeks. Christine straightened as competitiveness flowed through her veins.
“What’s the time frame?”
“Ideally, as soon as possible, but practically speaking, in a month.” That sounded like the same thing to Christine, but she only lifted an eyebrow and smiled. George grinned and ran a hand through his bristling hair. “Great! I can’t wait to see what you come up with.”
“Neither can I,” said Christine.
*
Now that two weeks had passed, solutions still seemed as obscure as Half Dome behind fluorescent glare. Christine settled her glasses back into the dents on her nose. She slid her pencil in a slow loop from point to eraser, eraser to point and tried to loosen up her thinking. Academic and industry analyses had shed no new light, and neither had Acme’s cost margins. She had tried to nip and tuck her way to significant savings, but no dice. She was running out of time, and she for damn sure was out of ideas.
“Dad, dinner,” pinged her calendar. She shut down her desktop computer and loaded her laptop into her cordovan briefcase, along with a steno pad and a pencil. Her intercom clicked on. “I have another call from Madison Wright. Would you like to take it?”
“No. Tell her I’ve left for the day.” Wright’s health care company, a burgeoning new enterprise, had been courting Christine for months. Ever the good soldier, Christine had declined the job offer, but a tiny part of her thrilled at the ongoing calls.
Her briefcase knocked against her knees as she crossed her office and opened the door to her admin’s space. Kathy Springer looked up in surprise, pulling her double chin into one long slope. The Mardi Gras colors of her blouse would have been just the thing on a cruise, but here they only accented the gray of her surroundings.
“Look at you, out of here before six!” said Kathy. “Headed somewhere fun?”
“Just to visit my dad.”
“Ah, you’re a good one.”
“You’re leaving soon, I hope?” asked Christine. It was a polite question. They both knew that Kathy couldn’t get her job done within an eight-hour day.
“Just another hour or two.” Kathy blew air under her bangs.
“See you in the morning, then.” Christine turned to leave, listing under the weight of her briefcase, then spun back to Kathy. “I almost forgot—would you requisition a new electric pencil sharpener for me? My old one is starting to bind.”
Kathy stared. “Surely you jest.”
“The hand cranks cost less over their lifetime, it’s true, but when you factor in the cost of installation by our labor, the electric ones aren’t bad.”
“Good heavens, cost is not a problem. I’m just surprised that you still use such a primitive tool. I may not even be able to find it in the catalog.”
“A pencil sharpener? They’ve become obsolete?”
“Pencil sharpeners, pencils. Who else have you seen using one in the past five years?”
*
The parking lot was almost empty now, and the evening was so cold and clear that it seemed the world would shatter with just the tap of a fingernail. As Christine drove downhill through barren landscaping to the four-lane highway, she pulled out her phone and called her father.
After four rings, he answered, “Hel-LO!”
“Hello, Dad. Whatcha doing?” Her voice rose in a girlish tone she never used at work.
“Oh, I thought you were another telemarketer. I’ve been trying to find the damned telephone.” In the background she heard pundits shouting from his television.
“I’m headed your way. Need anything?”
“I have a list somewhere. Hang on while I find it.” She heard the phone clatter down, then curses and paper rustling. Ahead of her car, brake lights stretched to the next rise in the road, blinking on and off as the cars crept along. Her father’s curses and paper slamming were still audible, and Christine’s shoulders began to creep up toward her ears.
He bellowed into the phone, “I can’t find it. Everything is so damned hard around here.” The phone clattered, then his voice returned. “Damn these telephones nowadays. They just fly out of your hand.”
Christine cleared her throat and tried to sound as calm as the slow-moving traffic. “How about I grab some milk, just in case.”
“That would be good.” He was calm again now that she was solving problems, not asking questions. “When will you be here?”
“As quick as I run by the store.”
A few minutes later her phone rang: her dad again. “Get me some Kleenex, too.” Long pause. “I think there’s something else but I can’t remember.”
“I’ll get the Kleenex, then,” she said, and hung up. She was in the grocery store, digging way back through the milk cartons to find the latest expiration date, just as he had taught her, when her phone rang.
“Get me some Kleenex and some toilet paper.”
When she pulled up to his apartment, she cut the engine and studied the tangled trunks of the adjacent state park. Such a restful place, she thought, but at forty-eight she was years away from being allowed to live there.
The door to his apartment was unlocked, so she walked on in. As usual, he was in his favorite chair, with his face to the television and his back to the door. For most of his life he’d been like quicksilver, slipping between structural design projects for sometimes twelve hours a day. Weekends were for home improvements such as building rock walls and patios. If he sat down in front of the television, he’d soon be snoring great blasts that threatened to peel back the ceiling. But now, after his strokes and as his back gave out from a lifetime of heavy lifting, he was always in the chair.
“Hey, sweetie,” he said without turning his head.
She hugged him, then pulled back. “You look great,” she said. Months after his cataract surgeries, she was still startled by the crystalline sparkle of his irises and the absence of glasses, which he’d worn all her life. “I’ll put your groceries away. You grab your coat and let’s go eat.”
It took him three tries to rise from his chair, this man who had lived his life not only by his wits, but his strength. “I wish I could just go ahead and die. I can’t do anything anymore.” He shuffled a few steps. “But that’s not for me to decide.”
He bore down on his walker as they angled down the sidewalk, across the parking lot, and through the main building to the dining room. “This place is more like a resort than a retirement home,” he said, with the same tone of amazement she’d heard at every meal. The two-story room with its views of wooded bluffs did indeed seem like a park lodge, but the diners were elderly, and walkers flanked the walls. Teenagers, the only speeding bodies in the room, ferried wee dollops of food to the tables.
Her dad settled into a rolling armchair. A skinny fellow with scrambled white hair leaned on his cane as he shuffled by. Her dad said, “Hello there!” Then he cupped his mouth toward the fellow and said, “No speeding, now!” As they chuckled together, their delight erased decades from their faces.
He and Christine crunched through the Friday special of catfish and hushpuppies. As shadows darkened the bluffs, their conversation dwindled. He pecked at his carrot cake parfait while Christine pleated and unpleated her straw’s paper wrapper.
“Dad, did you ever have a project you just couldn’t figure out?”
When she was a child, her mother would be in the midst of a long piece of gossip when her father’s face would go vacant. After a bit he’d say, “Excuse me,” and wander off to solve some design issue. Now he had the same expression.
“Not that I can remember. Sometimes it’s hard to see it, but there’s always an answer. Always.” He forked in a bite of cake, chewed and swallowed. “I had a tendency to make things too complicated. I’d load a design with too many elements until finally I’d realize my mistake and strip them away.” He tilted his coffee cup, then settled it back in place. “Simplest is usually better. The more complicated things seem, the more you need to make it simpler.”
Simpler. Simplify. “You mean like the Thoreau quote?” Christine Googled, then read aloud: “Our life is frittered away by detail. Simplify, simplify.”
“That’s it,” he nodded. She stared at him, so still that she heard the blood pounding in her ears.
When Christine left her father that night, Henry David Thoreau seemed to be pacing alongside her in his beard and frock coat. The cost of health insurance had always had a simple solution, but she’d dismissed it out of hand, time and time again. Yet what were her marching orders? “No sacred cows.” She poked at her idea, recoiled, but then poked again. It could work. It was bold, no doubt about it, but as requested, it was leagues away from the metaphorical box.
The next morning, Saturday, she rolled her data into a report. Her deadline was still almost a week away, but by the end of Monday she’d created a persuasive presentation. The numbers worked. At nine o’clock on Tuesday morning, during her usual meeting with George, she slid her report across the table to him.
He picked up the sheaf of papers. “What, you’re early with this? Clearly, I gave the assignment to the right person.” He flipped through the report, then turned to the introduction. His eyes flicked up at her. “Give me your top line.”
“I’d rather you just read it,” she said.
His forehead corrugated, but he studied the first page, eyes zipping from margin to margin. He paused, went back to the top of the page, and then lifted an intense gaze to her. A smile crawled across his face.
“Thirty-four percent savings?” He yipped like a fox as he rolled back from the table. “Finally, a plan that can save our bacon. ‘By drastically decreasing the insured population.’ Of course, that has always been the only way. To insure everyone is madness.” He glanced up at her again. “I’m glad you had the courage to call the right shot. Don’t worry, you’ll get the credit for this.”
He pulled back to the table and once again riffled through the pages. “Get rid of the deadbeats, that has always been the answer.”
Christine shifted in her seat. “Read the conclusion.” Her foot jiggled.
He turned to the last page and scanned it. He paused, looking winded, and read it again. Slowly he paged back through the cheerful pink, blue and yellow charts. He lingered over the subheads and demographics, then returned to the conclusion.
“This is a joke? You’re softening me up for the real data?”
“No sir, I am serious as a heart attack.” The joke failed to land.
He leaned his head on a hand. “The elderly? You want to drop coverage for the elderly?”
“Just over the age of sixty-five, when sixty percent of their health spending occurs. And if we roll back coronary coverage for all ages, we won’t have nearly as many people reaching sixty-five to start with.”
Supporting his head now required both hands. “Christine. This is insane and inhuman. Good god, woman, think of our parents.”
“I did. I believe my father would be grateful for this, and he’s one of the lucky ones who can afford an excellent retirement.”
George’s breathing was ragged. “I can’t take this to our board of directors. You know how old they are.”
Christine settled both feet flat on the floor and leaned forward from the hips, back straight and hands in her lap. “It is the simplest, most humane solution. We insurers have dug our own graves by prolonging life as long as possible. The only answer is to stop prolonging life. Just stop.”
“You have well and truly lost your mind,” said George. “You’re a good soldier, but you have lost your mind.”
Christine shook her head so subtly that it might have been a tremor.
He tapped the pages as his breathing slowed to normal. His eyes narrowed to thoughtful slits. “What’s your B plan? Surely you have one.”
Christine clasped her hands until they mottled puce and waxy white. “Maybe.”
“Anything you could polish up in a week or so?” He took her silence as a yes. “Give it another run, then.” He handed her the report. “And please, try not to scare me to death.” He reddened. “Or is that part of your new insurance plan. Surely not; I’m only fifty-three.”
Christine flushed and gathered the report. She left in a whoosh of silence. As she was pulling the door closed, she heard him pick up the phone.
It was a long walk back to her own office, and try though she might, she could not conjure up Thoreau’s comforting presence. She passed Kathy talking on the phone and tapping an image of a pencil sharpener on her monitor. “If you don’t have it, why is it still being advertised?” A voice squawked through the receiver. “Surely there’s one lurking around somewhere. Maybe in returns. Humor me and give it a look.”
Christine caught her eye.
“I’ll get this done one way or another,” said Kathy.
Christine smiled. Good soldiers were hard to find. “Thank you. And would you hold all calls until lunch?”
Kathy nodded, phone at her ear, and turned back to the monitor.
Once safe in her office with the door closed, Christine flung her report on the floor and wished for an explosion rather than the whiffle of pages. She stalked to her desk, pushed off in a spin, then paced to the far wall. She considered smashing the glass on the image of Half Dome, but instead spun back around and kept pacing. Finally, like a pendulum winding down, she came to rest near the splayed report. She scooped it up, smoothed the pages and wandered back to her desk. Easing into her chair, eyes on the cover page, she groped for a pencil. The first few taps were slow, hesitant, then sped to a rattle.
She paged through her contacts list, found the name and number, and dialed.
“Hello, this is Christine Wilson returning a call from Madison Wright.”
“Can you hold, please?”
“Certainly.” The pencil tap was steady now, deliberate.
“Christine! Good to hear from you. You’ve reconsidered my offer?”
“Possibly. I’ve worked up a fiscally responsible way to approach health insurance, but my company won’t consider it.”
A long pause. “Interesting. Is it legal?”
“I don’t see why not, for a private company. You’re looking to grow in unconventional ways, are you not?”
“We are indeed. We aren’t afraid of risk. What’s your angle?”
“We take on the real problem: the aged.”
“You mean euthanasia?” Wright’s voice rose. “That is most certainly illegal.”
“No, no, we just let people die of natural causes. We stop foiling nature.”
The silence went on so long that Christine wondered if the line was dead.
“And how do you define old age?” asked Madison.
“The costs really spike at eighty-five, but our best savings come by cutting coverage at age sixty-five.”
Silence. Christine’s head slumped forward, creeping toward her desktop. “The numbers work.”
Madison’s chair creaked and she sucked in her breath. “Could you come talk this over tomorrow?”
Appointment made, Christine settled the phone in its cradle. She jammed her pencil into the old sharpener. Whirrrr, loud and long as a planing saw, until it chewed the pencil down to the metal band.
~