Looking Back on Rheumatology in 2015, Leaping Forward to the Year Ahead

Image Credit: Hanna Hrakovich/shutterstock.com

My dear friends, we come to praise Caesar. As we march toward 2016, we ought to acknowledge the great Roman emperor’s role in creating a proper calendar.

At the start of Caesar’s reign, the calendar year lasted 355 days, 10¼ days fewer than the time it took the earth to fully orbit the sun.¹ Although this recurring deficit was supposed to have been corrected by the periodic insertion of an extra month here and there, this intervention had been largely ignored. In 46 B.C., Caesar commanded his timekeepers to extend that particular year by an additional three months and to begin adding a corrective intercalary or leap day on an intermittent basis.

Although the Roman mathematicians thought they had finally solved the issue, their fix was incomplete because, in reality, the solar year is a fraction shy of its previously recognized length of 365¼ days. Over the centuries, these small errors added up, and it took a papal edict issued by Gregory XIII to insert the corrections that serve as the basis for the calendar that we use today.

All in a Leap Year

The quadrennial leap year has its merits and its faults. These are the years when Americans are forced to endure seemingly endless presidential campaigns. Elsewhere on the planet, the spectacle of the Olympic Summer Games is being held, usually amid some form of controversy. The leap year is also linked to a number of matrimonial dos and don’ts. According to Irish tradition, the leap day is the only day when a woman can propose marriage to a man. If, however, the man refused the offer, he was expected to buy his spurned suitor 12 pairs of gloves, presumably to allow her to hide the embarrassment of not wearing an engagement ring. In contrast, Greek and Ukrainian superstitions steadfastly advise against leap year weddings.¹

In the economic sphere, the added day may foul up budgets that are calculated on an annual basis. For those of us who are salaried workers, the labor we perform on Feb. 29 is provided gratis. Recognizing an overlooked opportunity, some regulators have carried this idea one step further. In an effort to cut costs, the healthcare authority in the province of Quebec, Canada, has declared that in 2016, hospitals will forego reimbursement for leap day, generating a savings of $48 million USD.² Shortchanging healthcare systems knows no borders.

Staying silent on the sidelines is never the way to sway legislators.

Even without having to resort to this clumsy accounting sleight of hand, U.S. insurers, pharmacy benefit managers (PBMs) and other major players have acquired considerable expertise in gaming the system to their advantage. And they don’t require leap years to arbitrarily change the rules to their advantage.