白內障手術失敗後/莊峻華

白內障手術失敗後/莊峻華

昨日左眼白內障手術失敗，眼科醫生認為，有一碎片白內障，無法

取出，惟恐掉到眼後，影響視力，其實我之左眼，已無視力可言，於

是我找到藉口，延遲購買機票船票到歐洲。早上，我到醫學中心，另

外一眼專科醫生辦公室，詳細作一手術後檢查，這位卡頗醫生問我，誰

作我右眼白內障？於是我驕傲之介紹，我們北醫出身之余大夫，他說他

聽聞過，於是馬上安排作戰計劃，多點幾種眼藥水，明日再來檢查眼睛，

再隔一日，就是週五中午，作第二次手術，用特別儀器，將碎片部份取出

，清除乾淨，他說白內障是鏡片，昨日科輔大夫置放者，也是鏡片，像是

隱形眼鏡鏡片，要麻醉後取出，清理後置放回去。

我在牆上掛圖，詳細白內障手術，眼角膜黑眼珠部份，長了一些白混狀色物

，就是固體白內障，這會影響到視力，目前就影響到左眼，近視度數，所以

我同意手術取出白內障，15年前，右眼白內障手術順利，當時年紀較輕，也

有關係，年紀稍大，白內障漸次複雜，我是屬失敗者百分之一之內。

傳統之白內障手術，是用聲納震碎白內障，真空抽出，若是液態白內障，則

自動流出眼外，這是近代科技，還有一種是雷設法，老人保險不出錢補助，所

以免談。卡頗醫生說他很專門，我也不多懷疑，此問題早晚要面對，早晚要解

決。

下午，科輔醫生有電話來，詢問卡頗計劃，我說四日內決戰，明晨再去檢查，

我眼睛病未發炎，並無疼痛，只是看不清楚，幾週前，我觀看大俠，柳生十

兵衛，也是單目行走江湖，大戰江戶群俠，當然他比較年輕，而且又武藝高

強，自然有許多美女粉絲，我只不過是要，行走歐洲，寺廟掛單而已。

Talking about Philippine/ Carlos Pueblo

Talking about Philippine/ Carlos Pueblo

 Yesterday afternoon, I was inside of a waiting room for surgery, I again ran

into a pair of senior Philippine nurses. Both of them could speak Amoy, a

southern Chinese language which we practice at home in Taiwan. I congratulated

her as usual for her fellow medical professional’s domination worldwide, not only

in the U.S., in the oil rich middle east, in Taiwan, but also in Japan. I also indicated

the cruise worker as well, they contribute their paychecks into their home nation

and make very much difference. Philippine is now 7% of GDP and taking over some

of the international investment from China.

It is because of lacking job opportunity, many Philippine national must work in the

foreign nations to earn a living, for example, working on a cruise ship. They work on

all kinds of task for a minimum wage of one thousand U.S. dollar a month for a 10

month contract. One thousand U.S. dollar is called 30k in Taiwan for an average

income of a college graduate in Taiwan, this number has been dropped to 22k under

current Nationalist’s regime of Ma, a merely 700 U.S. dollar a month if you are hired.

In addition to that one thousand U.S. wedge, the cruise provides room and board plus

a free travel around the world. Those young workers would mostly send their income back

home for their family as long as for those Philippine labors all over the world. This is

a phenomenon.

She mentioned that the current Philippine President was not quite appreciated for this

Phenomenon. Aquino disregards it as insignificant while I disagree. I believe that there

Is a hope that many southeastern Asian nations may have an opportunity to break out

of the slavery past through this phenomenon by working very hard to accumulate a much

needed capital for the future adventure which we shall see.

講到菲律賓/莊峻華

講到菲律賓/莊峻華

昨日，在眼科手術室，又遇見一群資深，菲律賓女護士，我讚揚菲籍

醫藥護理人才，說是壟斷美國醫護界，其實包括全球各地，全球菲國

工作者，寄回之外匯，已經幫上該國經濟發展，我注意到此股力量，

是在第一次郵輪旅行，船上服務者，多半是菲國青年，有很多傳說，

這些人之待遇，我算一下，比台灣之30k好，30k就是每個月三萬新

台幣，在馬英九總統任內，甚至降到22k，約是700美金，郵輪工作者

，包括食宿。

我在台灣，台北或是虎尾，都看到菲律賓老人看護，在台北有菲律賓

雜貨店，服務菲律賓居民，我看到菲國威士忌酒，也參加過一菲國人

生日派對，長榮有飛機從休市，直飛台北，再飛馬尼拉。我發現菲國人

，腳踏實地，勤奮工作，所以遇見菲國人，我都說是老鄉親，我們祖先

，可能都是來自菲律賓等大洋洲人，我說是台灣平埔族人。

今日正逢股市大跌，我的菲律賓護士，正在找我的靜脈，說是要賣掉股

票，找到靜脈，才能掛上葡萄糖靜脈注射，我連忙感謝她之耐心，她來

自宿霧市，能言閩南語，我說是台灣話，我說找不到靜脈，是因為我未

進食物，我說腹肚邀，她說令她想起其父。

也有台灣商人，開始在菲國設廠，有很多台灣青年，開始在菲國工作，

先父有位舊識，劉梅生居士，後來以覺生和尚圓寂，劉教授夏門大學畢

業，是宿霧華僑，曾是弘一弟子，在宿霧辦過幾所佛較高中學院，像普

賢中學等，宿霧在呂宋島南部，將來找機會，拜訪菲律賓。

Cataract surgery/ Carlos Pueblo

Cataract surgery/ Carlos Pueblo

I have my left eye’s cataract removed due to the improvement of my

Left eye’s vision, yet the procedure has not been successful; therefore,

I have to visit another ophthalmologist, an eye specialist, in the medical

center area for another procedure. He might have better equipment

to finish the job.

My eye doctor has had 5 procedures in the afternoon, most of us are

senior citizen who have this kind of aging process. My right eye surgeon

15 years ago, told me that the older you are, the higher unsuccessful rate

encountered. Actually I am not that old yet I grow cataract at younger age

in compare with the rest of my family. I believe that my body is different

from the others and not because that I have a bad luck.

The surgeon put a lens, like a contact, into my left eye. This will make my

vision 2.0 for the left eye as my right eye. I cannot see well now and I hope

the retina is not damaged because I am not concerned with the residual

cataract will grow back that soon as long as I can see well for the time being.

This is what I am going to tell the new specialist.

I have to postpone my purchase of tickets, airfare and cruise, for my next

Trip to Europe in three weeks.

  

白內障手術/莊峻華

白內障手術/莊峻華

我作白內障手術，為使增進視力，手術原是簡單，結果因為我的症

狀特別，眼科醫生，有困難完全除去，所有白內障，立刻要我翌日

拜訪一位更專門之同事，他說這位同事，說不定有特殊之儀器，可

以解決我之困難，我想如果移除未淨，也無所謂，我看醫生護士，都

盡力工作，我非常感激，上次我右眼白內障余大夫曰，年紀大會有狀

況，上次手術順利，眼睛視力，變成2.0。

回家後，真的看字不方便，因為不戴眼鏡，無法看字，現在只有右眼

之2.0，沒有老花，左眼上繃帶，而且已有2.0鏡片在內，寫字和看網

路新聞，需要戒舊近視老花雙用眼鏡，真是不順利，還好手術全部是

老人保險補助，只交專科和手術掛號費。

像這種專科小手術，已經改在醫院外執行，我看環境也很好，我在手術

房外等候，這等候室當日，都是我醫生病人，一共五位，護士約有十位

，兩位麻醉醫生，開刀一位醫生，麻醉要在進開刀房，始打上兩劑，然

後就聽到醫生之聲音，我看超過原定半小時時間，就知道我這老頭，白

內障頑強不化。

出開刀房，醫生已經安排好，另外一位專科醫生，是在醫學中心，我讀

他的專長，是視網膜，是不是我有視網膜問題？但我手術眼睛，毫無疼

痛發炎跡象，只是看不見，看不清楚。

安排歐洲旅行，只好延後一週。

Stock collapse 2015/ Carlos Pueblo

Stock collapse 2015/ Carlos Pueblo

I was waiting for a left eye’s cataract procedure this morning, the internet

News broke out that Chinese stock Index collapsed 8% and Dow Jones went

Down one thousand points. I immediately released an article on my blog for

The record that it was a correction, the stock market just ran into the bottom

of the curve. Most of my retirement fund is in the stock market and I have been

through at least two bottom in the past 28 years, 1987 and 2008. The market always

comes back.

First of all, let’s talk about Chinese market. The Shanghai Market is very small in

compare with Chinese Economics and also, Chinese security is very exclusive only

for Chinese citizen investors. The Chinese market has been up more than 100 percent

for the l2 months and downing 40% is still ahead of a year before. Chinese government

attempted to save the market by increasing their currency circulation just lake U.S.

, Euro banking, and Japan, by this method, diminishing   its currency also increase its

export. China is facing something that U.S., Japan, and Taiwan have been through.

Chinese labor costs is getting higher than its neighbor Philippine, Viet Nam, Thailand etc.

The factory is moving out of China so in international investment. It is very difficult for

Chinese economics to maintain double digit growth any longer, a 7% increase for China

this year is very good in economics point of view like 3% increase of U.S. economics.

This rate is why U.S. unemployment rate is about 5%, a sign of fully employed nation.

1987 and 2008 were both under the Republican administration, Ronald Reagan and George

W. Bush 16 years in total duration. We saw the boon and the bust. Stock collapse 2015 is more

similar with year 2000 while at the end of Clinton administration with a stock correction.

The Central Bank did relax some currency  by lowering the interest rate for housing industry

to create a fantasy of housing boom and the result of a bust in combine with a trillion war

expanse. We do not have both of them this year. Once the market reaches to the bottom,

the only direction of the market is only up and up we go.

I have not complain for my saving in the security market throughout my working years. I

Had taken out of my saving principle during my unemployment time to support the family

Including two kids college education and the left over is really the growth of such investment.

Obamacare 2015/ Carlos Pueblo

Obamacare 2015/ Carlos Pueblo

A friend refers a prospect to me for health insurance because they both

are unemployed. I say that is Obamacare, a kind of National Healthcare.

It is not because that I am lazy and ignorance for the subject, it is due to

the complicity of the subject that I have already given up any attempt to

serve my prospect if there is any. First of all, there is a market in Houston

area that the insurance carrier is providing the product. A prospect can

either goes to an insurance of that company to check on the premium or

goes to the government website to find out the rate. In this procedure, you

have to answer the income information in order to find your rate. You will

get less discount if you have higher income or vice versa. I never attempt to

find it out after I attend two meeting from a carrier; however, Hillary Clinton

and Paul Krugman both indicate that Obamacare enrolls additional 16 millions

nationwide, so I say a big step towards elimination of uninsured U.S. population.

This prospect has the same difficulty which I have encountered between 2001

and 2012, unemployed and without insurance. I explained how I tried to get an

insurance through different jobs without success. It was very stressful, especially

that I had a pre-existing condition, diabetes. Her son is 25, at least we can get him

under his own policy with Obamacare with a reasonable rate because he has no

income and no asset if that is also under consideration. Then, she must keep her

husband’s Cobra, an 18 months extended policy, and aggressively solicit a new job

with a health insurance attached, both of them.

Secondly, if the job just does not come by. I agree to her original intention that to

dedicate to her religion to serve her God full time. Let God help her in this matter,

as a matter of fact, there is one denomination in the Protestant, the Christen Scientist,

who does not believe modern medical technology but praying to God for answer.

In order to get the Medicare, her husband must complete additional one year earned

income job before 65. I had already completed the requirement when I was unemployed

in 2001. Then I built up my own strong mind to be a self- insured with my IRA and saved

that $1,200 a month premium for 11 years.

It is true that at the end of that period, I did save up to $150,00 by paying back the numerous

0% percent interest credit card debt. I shall find time to write about it in the future. I was

under a very restrict diet, vegan not animal product, 2 miles daily walk with my dog, and

two or three nights tennis a week and finally, I reach to Medicare. At the end of my tenure

without health insurance, Obamacare, Affordable Health Act, is established.

歐巴瑪健保2015/莊峻華

歐巴瑪健保2015/莊峻華

客戶介紹朋友來問，歐巴瑪健保，美國保守派人，不喜歡此名稱，共

和黨人聲稱，執政後一定廢除此健保，共和黨人反對此法，因為認為

這是一項社會福利，美國窘困財政，無法維持如此新增預算，所以有

兩位該黨總統候選人，威斯康辛州之華特州長，和佛羅里達州如彼歐

參議員，提出工作者節稅計劃，其他15位候選人，尚無人跟進，這對

來電話者夫婦，最近失業在家，年紀約在55歲，並且有一25歲男孩，

尚在就學，先生前任職公司，給予退職人健保計劃，約是一千五百元

一個月，問我能否幫忙？我了解目前並無私人保險計劃，都需要經過

歐巴瑪健保規格，全國已經有新增一千六百萬投保者，這是希樂莉‧

克林頓提出之數據。如此說來，美國尚有兩千六百萬人口，沒有保險，

其中有幾百萬人，因為昂貴，選擇罰款了事，我了解共和黨國會，在

健保預算上，絲毫未讓一步，而且對非法移民，更加嚴格限制，不願

增加任何負擔。

我覺得歐巴瑪健保，是件好事，有意義之法律，所以兩次大法官會議，

都認定是合法，於是我建議兩夫婦，努力尋覓工作，只要有一人找到

工作，立即有保險，因為歐巴瑪健保，有此規定，若要留在美國，就

要專心一意，進入美國制度，絕對不能眷戀，英國和澳洲後退之路，英

澳兩國，社會福利制度，可能較優，因為國民所得稅高，用來貼補社會

福利，美國幸好有保守共和黨人制衡，限制社會福利支出，這些都不是

我們一般老百姓能所控制，要想辦法，在美國生存下去。

我有11年，梅有健康保險，我隨時都在找工作，找有保險之工作，有三

次找到，三次都失去工作機會，幸好小孩們，學校畢業後，均找到有保險

之工作，我也看開一切，注意身體，矜矜業業，一直等後到老人健保，如

果當年有歐巴瑪健保，我想家人應該較為放心，我以為政府應該多放預算，

來幫助國民，取得健康保險，所以我是自由進取派，美國有此能力。

歐巴瑪健保實施後，保險界和醫藥界，有顯著之改進，很明顯者為，每年

漲價保費，漸漸穩定，美國政府，也有許多辦法，來控制效率，我個人覺

得很滿意老人方便保險，我覺得保險公司，管理有效率，該做之醫學預防

工作，都甚盡力，按照紐約時報之專欄，保羅‧克魯曼文章，美國民意上

，顯示國民對全民健保，多數滿意，尤其是老人健保，有朝一日，政府開始

補助歐巴瑪健保，將解決剩下無保險者，國民將更滿意。

The Cataract’s removal/ Carlos Pueblo

The Cataract’s removal/ Carlos Pueblo

I have an appointment to remove my left eye’s cataract Monday of next

week. Even with near sight eye glass, my left eye’s vision is not as well as

my right eye because the right eye’s cataract has been removed 15 years

before. Right eye has a 2.0 vision while left eye glass is 700 degree near

sight. After the procedure, both eyes shall have 2.0 visions and I only shall

be required far sigh glasses while reading. A plane pairs of shades will do

during tennis or driving. I have plenty of supply at home from my daughter’s

left over at a welcome new employees party one year.

The reason why I had the right eye cataract removed because at that time

the near sight difference was more than 600 degrees between both eyes

which was exceeding the limit for preparing the near sight glasses. Therefore,

the eye doctor removed it and made it less than 600 degree difference. Now

the left eye’s cataract mature and again the difference is greater than 600

degrees between eyes. One surgeon asked for a laser procedure and the

second opinion was the traditional suction method. I accept the later due to

the cost on my part, laser method will cost $1,900 one eye while the traditional

method will be reimbursed most by the insurer. The eye surgeon is an Indian

ophthalmologist whom I get to know at a healthcare fair.

The procedure was set a month later due to his schedule including the pre-approval

from the insurer, left eye measurement, and consultation. The last two days when

procedure date approaching, I received two calls from the surgical center to prepare

the work and some physical checkup list, of course, a pre-surgery examination of

heart issue EKG was done before. The preparation even requires avoid blood thinner

such as baby aspirin. I feel that provider involved all very careful and will not let

the malpractice matter occur.

After the procedure, if successful, I shall have a perfect eye vision on both eyes. I no

Longer need to wear glasses instead two small lens inside my eyes. I shall be free on

near sight spectacles ever since teen age time.   

除白內障/莊峻華

除白內障/莊峻華

 下週一，我有約除左眼白內障，左眼近視約七百度，就是配上近視

眼鏡，也感覺不若右眼，右眼15年前，已經開過白內障，眼睛上裝

有一鏡片，視力是2.0，待左眼手術完成後，我就兩眼都是，視力2.0

，可以開飛機矣，平常無需帶眼鏡，讀書看報紙，只需老花眼鏡而已，

我連忙準備好，幾具墨鏡，琳兒公司，每年新職員訓練，留下一些連

價墨鏡，堅固耐用，有一式甚至骨錐，還剩兩具，其餘無人要者，我

當晝寢遮日光用，我天天都晝寢幾次，子曰宰予晝寢，朽木不可雕也。

右眼白內障之發現，因為兩眼近視度數，相差六百度，眼鏡師大夫，無

法調配眼鏡，建議我找眼科大夫手術；現在左眼七百度，右眼零度，眼

科醫生都鼓勵開刀，開刀有兩種方法，傳統方法，聽說是真空抽除白內

障，另外一種是雷射，雷射要價一眼一千九百美金，我馬上投降，一位

新遇眼科醫生告知，仍舊可以使用傳統方法，就是我上次右眼真空抽除

法，老人保險幾乎包括全部，於是我就欣然同意，這位青年印度人醫生，

就是在門診中心之，健康預防檢查集會中，前來值班之專科者。

手術定在一個月後，顯然一切都需要保險公司批准，之前，開始量眼睛

資料，護士開始說明，準備工作，那些眼科儀器，都是德國製造，保險

公司，也寄來賬單，一項一向列出醫生要價，一項一向列出核准價目；

手術準被問題，心電圖，服用藥劑，和病歷等，一一核對，開刀時，專

門護士，麻醉護士，甚至手術後，接送人都需查對，就是要避免意外瀆

職，給律師機會找麻煩，我發現此為改進中之，美國國家健康保險。

去年，我的西班牙語老師曰，老花眼鏡，其時只有兩種度數，十度和二

十度之別，男女均同樣式，一只老花眼鏡，約是十元美金，過去有人贈

我一袖珍老花眼鏡，搬家後已經不見蹤影。

Improving National Healthcare/ Carlos Pueblo

Improving National Healthcare/ Carlos Pueblo

Yesterday afternoon, I visited my brother Yancy for a small business matter.

We had chatted about Medicare, a major part of the U.S. National Healthcare.

He and I have been in retail insurance business for more than 30 years and we

all have had a certain degree of understanding of health insurance especially

from the cost point of view. He mentioned an example of Medicare, one of his

clients involving an injury, an internal bleeding from removing a tree branch

accident. When he realized the injury consequence, he had been sent to the

emergency room waiting for a low blood pressure specialist.  His Medicare

Plan, Medicare Advantage Plan, has only two of this kind of specialists and

the hospital could not wait but use its own specialist. The life was saved and

yet there was a cost issue due to that specialist was not under HMO Plan,

a Health Maintenance Organization under the Advantage Plan. Yancy tries to imply

that regular Medicare Plan plus Plan B, supplement F, and drug plan D is better

than Advantage Plan. Of course, that kind of plan can cover HMO and all other

selection of providers, a Preferred Provider Organization or PPO. But the cost

is higher.

How high is it? A regular Plan you do not pay any for A part, surgical and hospital,

because you have already paid in full during your earned income years. B part,

physical cost, is about $105 a month; supplement part which I define it as C part

for F Plan is about $170 a month. This is for something like deductible of something

which Medicare does not cover. I figure that amount is not over $70,000 benefit.

Drug part D is about $17 a month. Advantage Plan takes A and B parts from Medicare

and will provide the identical coverage under its HMO network. The principle is the

same as Obamacare for under 65. The more premium you pay, the fancier plan you

will receive.

I have my old man health insurance under Advantage Plan. I am very satisfied with

the providers’ service, so far so good. I believe that the carrier is also making good

profit out of it because you can see the merger activity of the huge health insurance

industry, a trillion dollars business annually. I notice that many of our community

second generation physicians are under my Plan network. I believe that their medical

school training are very solid and reliable. There are several reasons to make National

Health Insurance to work better than previous healthcare system. I believe the industry

and the government are working together towards the same goal by improving the

efficiency of the Plans. Most of the customers do not need to waste a lot of luxury Plan

if you are not sick.

改進之全民健保/莊峻華

改進之全民健保/莊峻華

昨日路過拜訪峻嚴，談到老人健保之選擇，他是一般選法，選擇購

買乙項，就是門診醫生部份，每個月約是US$105，，然後再增購丙

項老人保險自備款部份，保額在七萬美金範圍內，保費每個月約美金

170元，然後再加購丁項藥費，大約是16元美金一個月，如此計劃，

可以選擇自己之醫生，自己之醫院等等，他認為選擇較多，服務效果

，應該較好，但是成本較高。我選擇者為，管理式健保，就是一種保

險公司，在老人保險辦法內，向老人保險局，取得甲項住院開刀險款，

還有乙項門診醫生險，然後賣給老人，服務之範圍，必需是在這保險

公司，組織內之醫事服務者，藥費也包括在內，所以我定義它為，改

進之老人健保，歐巴瑪健保，也有如此之選擇，所以我說是，改進之

全民健保。

我是選擇後向老人健保，因為比較便宜，而且服務非常好，我的家庭醫

生是艾力克‧蘇大夫，是我們蘇大森李和美同鄉夫婦之長公子，但是我

看不到他，被安排給另外一位美國醫生，也很親切，最近又看到一位年

輕之華人女醫生，也非常能幹，很有效率，這診所有17位醫生。因為我

有糖尿病，所以要定期追蹤眼睛微血管，有無糖結晶，和此保險公司契約

之，眼科集團更大，邱忠男公之愛婿歐大夫，和鍾萬隆長老之長公子，都

在集團中，很有趣者，兩位大夫，我第一次均排不上門診。過去我有上述

首項保險20多年，就是自己可以選擇醫生醫院者，我深覺不若最近三年內

之後者，我說這些年輕醫生，醫事技術之養成，更為堅固結實，而且更有

自信，再加上病人之相信度，改進之健保，更加進步合理。

每個月，保險公司寄來支出報表，主要是專科醫生和手術費用，醫生和手術

中心，報出一天文數目，然後有保險公司核准數目，非常有趣，這就是管理

法，專科醫生無需考慮許多做人道理，只要專心做事，家庭醫生診所，大概

是由保險公司，按月岸病戶計酬，所以誰門診都一樣，保險公司也賺錢，所

以都在買客戶，大公司合併，動輒幾百億美金成交額，畢淨美國醫藥費用一

年上一兆美金。

美國健保，不斷改進，自歐巴瑪健保實施後，增加一千六百萬人口，進入健保

，我看共和黨人，不爽歐巴瑪健保，開始提出更換計劃，主要是稅務優待，有

工作者，始得享受到，共和黨內意見尚未統一，否則，共和黨已經控制國會，

可以改進健保多時矣。