© - Steven A. Cerra, copyright protected; all rights reserved.
“If Denny Zeitlin was a few years younger and played sax instead of piano and
hung with Toni Tennille as well as Matt Catingub, he might have been Doc
Stewart. A hot shot at Mayo Clinic, Stewart was a muso before he was a doctor and he still plays with the passion of someone that would
do this whether or not he could make a living at it or not. Far from being the usual busman's holiday record, Stewart was a pro before
he settled on a day job and he's never lost his chops. Straight ahead stuff with an edge that that really cuts to the chase, even without
a scalpel. Hot stuff. “
- CHRIS SPECTOR, MIDWEST RECORD
Twenty-five years ago, there were over 90 Health Maintenance Organizations [HMO’s] in California. Many were only city or county based, but most were regional and statewide.
Today, there are fewer than 10. One result of this consolidation, is that the remaining HMO’s are statewide, some are in multiple states and about half are national. If you live in the USA, names like Aetna, Blue Cross and/or Blue Shield, Cigna, Kaiser and United Healthcare should be familiar to you.
Enacted by Federal legislation in the early 1970’s, Health Maintenance Organizations never lived up to the “health maintenance” promise inherent in their name, but what they did do was loosely combine hospitals and physicians or, if you will, inpatient and outpatient care, into one healthcare delivery system.
Before the current consolidation of insurance companies offering medical coverage, many of these these HMO’s or healthcare delivery system also took risk; i.e. - became health insurance companies.
Very few insurance companies keep all of the risk they undertake [or, to be more precise, underwrite]. They usually lay some of it off in the form of reinsurance and they use a reinsurance broker to place this “excess capacity.”
Reinsurance intermediaries, “the bookie’s bookie,” if you will., place the layers of coverage for the amounts of risk that is being transferred by the healthcare delivery system [excess capacity] with those insurance companies that specialized in insuring insurance companies. Probably the most famous name in reinsurance is Lloyds of London in England although there are many huge entities specializing in reinsurance in France, Switzerland, Germany and Italy.
There is a constant battle between the heathcare delivery system [aka hospitals and docs] and insurance companies [and their reinsurers] because the former wants to spend whatever it takes to help people recover from their illnesses while the later wants to have some degree of sway over the medical claims that the hospitals and docs submit to them in order to control their costs and make a profit.
Associated with this struggle is a universal misunderstanding on the part of the general public that somehow health insurance companies should be in business to go broke; not surprisingly, the people who operate insurance companies [and their reinsurers] do not share this view.
Periodically - usually at the time of the reinsurance renewal - claim trends are examined and efforts are made by the insurance companies to mitigate costs and thereby help keep the reinsurance renewal “affordable.”
Because I once worked for a company that delivered care as well as took on insurance risk, I got to see firsthand what was involved with both sides of this dynamic.
By far the most expensive unit of medical care was the Emergency Room [Burn and Brain trauma intensive care ran it a close second].
This was especially the case if the Emergency Room [ER] was located in a large metropolitan area where the medical specialists had to be able to handle gun shot wounds, stabbing and other forms of violent injury.
Brute force trauma causes unimaginable consequences for the body to cope with and Emergency Room doctors have to provide split second care to help prevent the death of a patient which, in many cases, is imminent. ER docs are a talented bunch and tres expensive.
Good luck “risk managing” the cost of an ER as the docs have to bring all their medical skills to bear to help keep these severely traumatized patients alive.
Is it any wonder that people who go to the Emergency Room with minor illnesses sit there for long periods of time?
And is it any wonder that given the almost prohibitive costs associated with maintaining them that many hospitals are deciding to close their Emergency Rooms?
The healthcare delivery system company that I worked for did as they eventually could not afford to operate ER’s any longer when insurance reimbursements for this type of care plummeted. It also exited the medical insurance business, but that’s a whole other story.
I was reminded of all this recently with the arrival of Code Blue! Doc Stewart Big Band Resuscitation [Cannonball Jazz CJ-2014].
The “Doc Stewart” referenced in the disc title is Chris Stewart who in real life is an Emergency Room Doctor at the world-famous Mayo Clinic, a world class technician on the alto saxophone and Julian Edwin "Cannonball “Adderley's historian.
He is also one heckuva alto saxophonist who has modeled his playing after the style of the late Julian “Cannonball” Adderley.
As Chris Spector states in the quotation from Midwest Records that opens this piece: “... Stewart was a professional musician before he settled on a day job [became an ER doc at the Mayo Clinic] and he’s never lost his chops.”
And if you going to play like Cannonball, one thing you need to have is chops [technique] to spare. If you are unfamiliar with Doc Stewart’s playing you are in for quite a revelation as he is a burner who can really bring it, chorus after chorus. Whether it’s a blues a ballad or a bop theme, Doc Stewart exudes excitement and his sound literally explodes through the instrument with a tone that’s full of what musicians refer to as “juice.”
Here’s some background information on the evolution Code Blue! Doc Stewart Big Band Resuscitation [Cannonball Jazz CJ-2014]:
"The concept of Code Blue! originally came from an idea to follow-up the 2005 CD Phoenix: A Tribute to Cannonball Adderley. Its popularity and success were attributed to the whole doctor-jazz musician thing. Therefore the follow-up CD would have a bent towards medicine and in particular emergency medicine -which is what Doc Stewart has been practicing for twenty-four years. Code Blue!, which is what is called out when a patient has a cardiac or respiratory arrest, seemed a good fit to merge emergency medicine with jazz."
"The big band Resuscitation reunites the band members of Doc Stewart's "pre-medicine" era who have gone on to become top studio and jazz musicians in the LA scene. The album features Doc on an eclectic collection of arrangements integrating the CD's original Code Blue Suite with a variety of favorite tunes chosen for their special meaning to Doc Stewart. This is especially true with the Cannonball Adderley Quintet arrangements.”
The arrangements are by Matt Cattingub and Tom Kubis and they are flawlessly executed by this top flight group of studio musicians:
Woodwinds: DOC STEWART; DAN HIGGINS; BILL LISTON; RUSTY HIGGINS; GREG HUCKINS; ALEX BUDMAN Trumpets: WAYNE BERGERON ; DAN FORNERO; JEFF BUNNELL; RON STOUT; KYE PALMER; LARRY HALL Trombones: ANDY MARTIN; ALEX ILES; SCOTT KYLE; BILL REICHENBACH; Piano & Keyboards: MATT CATINGUB Acoustic & Electric Bass: KEVIN AXT; Drums: STEVE MORETTI.
If you are a fan of big band Jazz, you know that it is always a treat to rediscover the explosive sound of Jazz when it is cleverly arranged for skillful musicians to play it in larger format.
Listening to Doc’s driving solos, the crackling brass, the unison saxophones and the popping rhythm section on the four-part suite and ten other tracks listed below that comprise Code Blue! Doc Stewart Big Band Resuscitation [Cannonball Jazz CJ-2014] reminded me of all the reasons why there is nothing quite like Jazz played in a big band environment.
1. Code Blue Suite (Tom Kubis/Chris Doc Stewart)
Code Pink - Born to See Blues (6:08)
Ironman Blues - But Seriously, Dig Me Man! (6:59)
The Last Breath Blues - All Alone Now (5:01)
Code Jesus - New Life! (5:41)
2. The Sticks (Julian Adderley) (5:25)
3. Homage to Bud Shank (Tom Kubis) (4:44)
4. Snakin' the Grass (Hal Galper) (6:26)
5. Patty's Bossa (Doc Stewart) (5:05)
6. Dis Here (Bobby Timmons) (5:59)
7. Introduction to a Samba (Julian Adderley) (5:11)
8. Poor Butterfly (Raymond Hubbell) (6:04)
9. Song My Lady Sings (Charles Lloyd) (5:07)
10. The Way You Look Tonight (Jerome Kern) (5:32)
11. Bohemia After Dark (Oscar Pettiford) (5:17)
The following video features Doc and the band on Tom Kubis’ arrangement of “The Sticks” by Cannonball Adderley. I put my own spin on the title of the tune which resulted in the graphics theme that is featured in the video. Doc Stewart takes the alto sax solo and Ron Stout plays the trumpet solo.