poem

 Value Based Care

The hospital system has asked me to reconsider 

My use of a certain kind of scissor 

Given my volume, they claim that switching 

Brands could save the system thousands

But I say I don't care

I have my reasons—

I like the way it works, it’s weight in my hand.

Mostly I just like how it cuts.

But they want me to be a better steward

Of limited hospital resources

And to take on the role of ambassador

For conscious value creation.

I don't know what any of that means

Nor am I interested in finding out.

It sounds like capitalist realism.

Oh, you haven't read it? You should.

To summarize: someone hands you a knife

When you’re bleeding. They tell you

To swim while you’re drowning. 

I can barely afford the dawn

And evening is beyond my means.

If you save a dollar a day

By the end of your life

You’ll have enough to pay

For the bagpipes at your own funeral—

Don’t put that on your poor wife.

We all have a fiduciary responsibility to those

Strategically positioned to reap all the benefits.

The mesh reps are taking us out to the steakhouse for supper.

I’m an old-fashioned guy and even I never say supper

Each bite of this overcooked T-bone is a conflict

Of interest and has to be reported on the government website 

Even the side salad that came slathered in bitter onions. 

But I’m hungry and I’m tired of Graham crackers.

I don’t have anything to do with negotiated contracts

I just use whatever mesh is left on the shelf.

Like an out of touch billionaire I have

No idea how much everyday items here cost.

If you told me scalpel blades were 85 bucks

A piece, I’d think that seems crazy high but hey,

What do I know? What do I care? Somebody needs it. 

Now our bosses want us to do a "compassionate pause"

Before we start an operation

Because the well compensated consulting firm found

That performative acts of empathy 

Generate higher patient experience scores. 

You can’t have a hospital without reimbursements

Nothing in this America comes for free

The federal government says every life is worth $13.1 million

Which factors in metrics outside the notion of mere net worth

But if you have that much in the bank it means you're worth that much

If you write a poem, subtract 75 cents

Save a life, it’s a rounding error

When you retire you get a Citizen watch. 

8/25/25