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Category: Medicine

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Garrison Keillor describes his stroke

What’s it like to have a stroke, then get really lucky? Garrison Keillor tells it like only Garrison Keillor can tell it:

[A] neurologist shook my hand and said: “I hope you know how lucky you are.” That was pretty clear as I walked down the hall, towing my IV tower, and saw the casualties of serious strokes. Here I was sashaying along, like a survivor of Pickett’s Last Charge who had suffered a sprained wrist.

What’s it like to get world class treatment for your stroke when you have a strong sense of social justice?

Rich or poor, young or old, we all face the injustice of life — it ends too soon, and statistical probability is no comfort. We are all in the same boat, you and me and ex-Gov. Palin and Rep. Joe Wilson, and wealth and social status do not prevail against disease and injury. And now we must reform our health insurance system so that it reflects our common humanity. It is not decent that people avoid seeking help for want of insurance. It is not decent that people go broke trying to get well. You know it and I know it. Time to fix it.

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Snoring: The Upshot

Snoring: The Upshot

Google “snoring” and you’ll get a flood of how-to advice on how not to, and a lot of reasons to stop. Not surprisingly, the majority of links recalled were advertisements for devices, medications, surgical maneuvers, and their purveyors. In today’s pharm-centered universe, the vibration caused by air traveling through our airways has been pathologized and vilified as the destroyer of otherwise sound relationships.

Not only is it bad for your love life. Snoring is deadly!

According to snoring alarmists, snorers who have the audacity to continue sleeping noisily can look forward to myriad cardiovascular disorders including heart attacks, atherosclerosis, and stroke, marital and erectile dysfunction (chicken-or-the-egg?), drowsiness, lack of focus and…Zzzzzzzzz.

Admittedly, I’m no doctor, but let me suggest that there are some positive effects of snoring (besides the possibility that it keeps you healthy by means of temporary asphyxiation). It’s a much cheaper and more effective method of subjecting those around you to intense jealousy (”Please, please, make him stop so I can lose consciousness ASAP”) than, say, buying a pair of Jimmy Choos. Then again, I don’t usually begrudge those masochists the pain of walking around…

But I digress. If you would rather not invest in a medical solution, you could try banishing the banshee by learning a new instrument. You guessed it: the Didgideroo!

Ah, it’s time for bed. Maybe the lumbering Saint Bernard downstairs will give it a rest so I can, too.

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How to have a conversation about health care reform

I commend the way that Al Franken engaged with these tea party folks recently:

Watching this video makes me ever more suspicious that the media is driving unnecessary conflict (on health care reform and on everything else) in order to sell ads. It seems much easier to talk when the media isn’t around spewing sound bites and featuring angry extremists, instead of focusing on the many ways we actually agree with those with whom we “disagree.”

I couldn’t take my eyes off of the woman who tried to start the conversation in a contentious way. I kept wondering whether her views on Al Franken were shifting given the impressive way he discussed the issues surrounding health care reform.

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Government-Hating: An American Value

Government-Hating: An American Value

G.O.P. Chairman Michael Steele made a few remarkably in-your-face comments recently about the health care debate. Here, in his own words, is pretty much where he thinks the nation is going, why it shouldn’t go there, and what the Republican Party stands for.

This morning on NPR he tangled with Steve Inskeep, in particular over this.

One quote in particular caught my eye: ” Simply put, we believe that health-care reform must be centered on patients, not government.”

When you listen to the NPR interview it’s clear that we’re hearing another in the now decades-long tirades against the government which has become the hallmark of Right Wing politics in this country.

In this country, in theory, the government is supposed to be us, the people. We elect our representatives, we tell them how we want them to vote, we change our minds, we are supposed to be in charge. In theory. Obviously, the reality is far from that. For one, we are not a full-fledged democracy, we are a republic, and while we elect those who operate the machinery of the republic on our behalf, we do not have a direct say in the running. Nor could we, really. it is simply too complex. We send our representatives to the various points of departure—state capitols, Washington D.C., county seats, city halls—to do that for us because it is a big, complex, often indecipherable melange of conflicting goals, viewpoints, and problems. We do not have the time to pay the necessary attention to do that work ourselves, so we pay people to do it for us.

So why do we distrust it so much?

Well, because we distrust each other.

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An army of 50,000 highly motivated citizens condemning health care reform

Who are all of those outspoken citizens attending the town hall meetings where health care reform is ostensibly being discussed? The Raw Story reports that 50,000 of them are not simply concerned citizens:

A spokesman for America’s Health Insurance Plans, the industry’s trade group, admitted in an article published Monday that as many as 50,000 industry employees are involved in an effort to fight back against aggressive healthcare reform . . .

“The health-insurance industry is sending thousands of its employees to town-hall meetings and other forums during Congress’s August recess to try to counter a tide of criticism directed at the insurers . . . Employees of the health insurers have also been given talking points . . .

Question: Who is more motivated to show up and speak up at public meetings concerning health care? A) Ordinary citizens or B) Employees of health care insurers who are being PAID to show up and who are being provided talking points? The obvious answer is B), and they are contaminating discussions from coast to coast.

The bottom line is that what is going on is not honest spirited debate out at town halls. Rather, what we are being subjected to is corrupted debate, to match the corrupted debate inside of Congress, where six highly paid health care lobbyists are assigned to each member of Congress, as reported by the LA Times:

Every one of those 534 members of Congress now has six (6!) lobbyists working on them — and that’s just for healthcare. A total of 3,300 lobbyists have registered to drive the sizzling healthcare issue in Washington — three times the brigade of lobbyists representing the entire defense industry.

It makes you want to throw up your hands (and sometimes, just throw up), thinking that we are sending sheep to the wolves whenever we hope that regular folks would be able to make as much focused noise on the topic of health care reform (and especially health care insurance reform) against financially motivated and highly-trained armies who are not attending these meetings to do anything other than advocate the pre-determined positions of their employer corporations and to prevent any meaningful discussion. Based on what I am reading and hearing, the presence of these highly vocal and highly biased participants is all the worse because they aren’t identifying themselves as such at public hearings.

In most things, we ask people of bias to identify themselves, because we should downplay the positions of biased people, because they are less trustworthy. They should be impeached for their positions of biased, the way we impeach biased witnesses in courtrooms. But there is no practical way to identify these financially motivated people at town hall meetings. They are presenting themselves are neutral ordinary citizens when they are anything but.

For me, this “health care” debate is increasingly turning into a question of how (or whether) we are able to have any meaningful national discussion where one of the sides is financially powerful. This is especially a concern where investigative reporting is disappearing (but thank you, LA Times).

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George Lakoff offers some framing tips to the Democrats re health care reform

Linguist George Lakoff is asking how a man who did such a marvelous job campaigning for President has stumbled so often on the issue of health care. Lakoff thus wrote an article offering some a list of language/framing advice to the Democrats. Here’s the foundational concept:

The list of what needs reform makes sense under one conceptual umbrella. It is a public alternative that unifies the long list of needed reforms: coverage for the uninsured, cost control, no preconditions, no denial of care, keeping care when you change jobs or get sick, equal treatment for women, exorbitant deductibles, no lifetime caps, and on and on. It’s a long list. But one idea, properly articulated, takes care of the list: An American Plan guarantees affordable care for all Americans. Simple. But not for policy wonks.

The policymakers focus on the list, not the unifying idea. So, Obama’s and Axelrod’s statements last Sunday were just the lists without the unifying institution. And without a powerful institution, the insurance companies will just whittle away at enforcement of any such list, and a future Republican administration will just get rid of the regulators, reassigning them or eliminating their jobs.

According to Lakoff, Obama needs to break out of his wonkish way of talking about health care. He is mistakenly operating on the principle of “policy speak”:

If you just tell people the policy facts, they will reason to the right conclusion and support the policy wholeheartedly.

Lakoff argues that “policy speak” is a big mistake. Mere facts don’t win arguments. Rather, the facts need to make sense to people, resonate with them and inspire them to act. Here’s Lakoff’s version of what should be Obama’s basic message:

Insurance company plans have failed to care for our people. They profit from denying care. Americans care about one another. An American plan is both the moral and practical alternative to provide care for our people.

The insurance companies are doing their worst, spreading lies in an attempt to maintain their profits and keep Americans from getting the care they so desperately need. You, our citizens, must be the heroes. Stand up, and speak up, for an American plan.

Lakoff has lots of specifics. For instance, remind Americans that health care is a patriotic duty. Highlight the phrase “doctor-patient care.” Deny that the insurance companies care; rather, they clearly communicate that insurance companies make money by depriving us of care. Hammer the phrase “insurance company bureaucrats.” Tell Americans that their health care premiums are “private taxes” levied by insurers. Remind Americans that health insurers “govern our lives.” Talk about the “failure” of insurance companies. The “villainizing of real insurance company villains should have begun from the beginning.

George Lakoff is asking how a man who did such a marvelous job campaigning for President has stumbled so often on the issue of health care. Lakoff thus wrote an article offering some a list of language/framing advice to the Democrats. Here’s the foundational concept:

The list of what needs reform makes sense under one conceptual umbrella. It is a public alternative that unifies the long list of needed reforms: coverage for the uninsured, cost control, no preconditions, no denial of care, keeping care when you change jobs or get sick, equal treatment for women, exorbitant deductibles, no lifetime caps, and on and on. It’s a long list. But one idea, properly articulated, takes care of the list: An American Plan guarantees affordable care for all Americans. Simple. But not for policy wonks.

The policymakers focus on the list, not the unifying idea. So, Obama’s and Axelrod’s statements last Sunday were just the lists without the unifying institution. And without a powerful institution, the insurance companies will just whittle away at enforcement of any such list, and a future Republican administration will just get rid of the regulators, reassigning them or eliminating their jobs.

According to Lakoff, Obama needs to break out of his wonkish way of talking about health care. He is mistakenly operating on the principle of “policy speak”:

If you just tell people the policy facts, they will reason to the right conclusion and support the policy wholeheartedly.

Lakoff argues that “policy speak” is a big mistake. Mere facts don’t win arguments. Rather, the facts need to make sense to people, resonate with them and inspire them to act. Here’s Lakoff’s version of what should be Obama’s basic message:

Insurance company plans have failed to care for our people. They profit from denying care. Americans care about one another. An American plan is both the moral and practical alternative to provide care for our people.

The insurance companies are doing their worst, spreading lies in an attempt to maintain their profits and keep Americans from getting the care they so desperately need. You, our citizens, must be the heroes. Stand up, and speak up, for an American plan.

Lakoff has lots of specifics. For instance, remind Americans that health care is a patriotic duty. Highlight the phrase “doctor-patient care.” Deny that the insurance companies care; rather, they clearly communicate that insurance companies make money by depriving us of care. Hammer the phrase “insurance company bureaucrats.” Tell Americans that their health care premiums are “private taxes” levied by insurers. Remind Americans that health insurers “govern our lives.” Talk about the “failure” of insurance companies. The “villainizing of real insurance company villains should have begun from the beginning.

I recommend reading Lakoff’s entire article, which is detailed, and thoughtful.”

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Who needs a public option anyway?

Who needs a public option anyway?

One of my republican friends asked me”who needs a public option, anyway?”over a beer the other evening. He was responding to my shout of dismay over Ms Sibelius statement that the public option was “not really necessary” to health care reform.

So who needs a public option?

People who are currently uninsured, of course. Most of them are not uninsured by their own choice, but by the choice of an insurance company. A few may have elected to remain uninsured even when eligible, due to cost of premiums, etc . Many younger colleagues fall into this latter group, which has the effect of raising insurance rates for everyone else (since the remaining population are older and higher risk)

People who cannot afford to lose their insurance. Many people maintain are locked in to their insurance because of conditions that would be considered ‘pre-existing’ by a new insurer. Even if able to be covered by a new insurer, their premiums would likely be higher, or their coverage would carry many more restrictions. Health costs are already high - who would choose to voluntarily increase their expenses while reducing benefits?

And people like me. I have a job. I am in reasonably good health, and have decent employer-based health insurance for myself and my family. But I am effectively locked into my current employment. I would love to start my own business, but I cannot afford to be without healthcare. Private healthcare is so expensive, my baseline operating costs would be simply exorbitant. The risk of starting a business is already high. The penurious cost of private healthcare makes a high risk venture, insanely high.

In my travels I meet a great many people - and many people feel equally locked into employment: “I’d love to quit this job and go do
X but I can’t afford to give up my healthcare”.

Lack of a public option is killing America’s spirit of entrepreneurship. It’s killing the goose that laid the golden egg. The ability of common Americans to start their own ventures without hindrance is central to the spirit of independence and vitality that made this country an economic powerhouse in the 19th and 20th Centuries. The fact that republicans are most viscerally against a public option demonstrates that they are not “for business”, but are simply and solely for “big business”.

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12 Reasons why the U.S. government should not mandate clean water or clean air.

12 Reasons why the U.S. government should not mandate clean water or clean air.

1. Clean air and clean water are not a right. As such, they not the responsibility of government.
2. Government efforts to mandate clean air and clean water do not in practice guarantee universal access clean air and clean water. Many countries have laws to require clean air and clean water but don’t actually have clean air and clean water.
3. Eliminating the profit motive will decrease the rate of innovation regarding clean air and clean water.
4. When a government mandates clean air and clean water, it slows down innovation and inhibits new technologies from being developed and utilized. This simply means that technologies regarding clean air and clean water are less likely to be researched and manufactured, and technologies that are available are less likely to be used.
5. Publicly-mandated clean air and clean water leads to greater inefficiencies and inequalities. Government agencies promoting clean air and clean water are less efficient due to bureaucracy. Universal clean air and clean water would reduce efficiency because of more bureaucratic oversight and more paperwork.
6. Converting to a national clean air and clean water system could be a radical change, creating administrative chaos.

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Who would Jesus insure?

Who would Jesus Insure?

That was the slogan on a placard that stole the show at a tea party attended by Michael Krantz yesterday:

[T]he Medicare recipients who want nothing to do with government-run health care [were] one of the more amusing right-wing cliches of this long hot August. There were no doubt plenty of them yesterday among a crowd that was predominantly older, overwhelmingly white and, I’d wager, heavily evangelical, a combustive demographic that didn’t exactly cotton to the gutsy girl who kept pacing around trying to yell “Health care for everyone!” loudly enough to drown out the repeated death threats and off-topic anti-abortion catcalls that greeted her homemade “Who Would Jesus Insure?” sign. Her question, in fact, was quite a bit more piquant than the ones I was asking.

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Did Obama fall for Big Pharma sales hype?

Did Obama fall for Big Pharma sales hype?

Did you hear that Obama has been cutting some secret deals with Big Pharma after his campaign filled with promises that health care reform would be a big open book? I don’t quite know what to think of this. Maybe Obama is leading Pharma on, and he’s gonna stab them in the back at the last minute. That ploy has the advantage of freezing the Pharma advertising money in place for now. This is important because Pharma has enough advertising money to destroy what’s left of health care reform. So three cheers for the possibility that Obama is a shrewd guy who is keeping his enemies close to keep them at bay, at least for now. I’d give that about a 2% chance of being the case.

What I’m assuming is that Obama knows that the system is so utterly corrupted by legalized bribery (campaign contributions) that Congress is incapable of giving us real health care reform. That’s why Obama is unwilling to promote the single payer system that most Americans want. In this more likely scenario, Obama has already given up on any meaningful health care reform. Instead, he’s working hard to spin the illusion of health care reform, and the final plan will actually be a few trinkets and whistles. Maybe the government will subsidize dentists to give out candy to their patients. Maybe it will be nothing at all, but all of the Congressional Leaders will nonetheless pose and smile with their 3,000 page health care reform bill that no one will have actually read and for good reason.

As many progressives are arguing, with increasing volume these days, why not take the profit out of health care insurance? Why not essentially expand medicare to all Americans? The experts I trust say that single payor is the only legitimate reform. Everything else is throwing tax money at a corrupt and inefficient system. I wasn’t a big fan of single payor until I started learning how many other countries are making it work. The benefits are many (In addition to the obvious improvement that sick people won’t be thrown on the street, employed people won’t be locked into terrible jobs just for the insurance).

Really, why should we have for-profit health insurance any more than we might have for-profit fire departments and for-profit libraries? Except that we have a for-profit Congress and a for-profit military (e.g., Blackwater and all those private soldiers earning $100,000 to be in Afghanistan). It’s getting downright un-American to be duped into doing something because it’s RIGHT.

But I’m still obsessing about the deal Obama cut with Pharma. We heard how Pharma would save Americans $80 Billion over the next 10 years. Did you see what the written deal is: It’s “up to $80 Billion.”

pharma-memo

Now what is Obama thinking? When I see that a store is offering “up to” 80% off, I know (because I’m not a total idiot) that this means the store might be offering 2 items at 10% off and everything else at 0% off. That’s the meaning of “up to.” Signing an agreement with “up to” is stupid, truly idiotic. My question (which I raised in the beginning of this post) is “Who is the one being stupid?” I’ll be watching for some happy 11th hour excitement when Obama tells Pharma to fuck off, that we’re enacting single payor and that for its loyalty and naivete, Pharma will be rewarded with tax breaks of “up to” 100%, which means negative 37%. Take that, assholes. That’s what you get for trying to cut secret deals with my President.

If only.

Epilogue: For those of you who are pissed that Obama is a communist, note that Blue Cross just tried to raised its rates by 56% in Michigan.

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Maddow and Olbermann counter-attack the elites opposing health care reform

Who are those “average citizens” disrupting town hall meetings on health care reform? Rachel Maddow exposes them and the people who finance them:

Visit msnbc.com for Breaking News, World News, and News about the Economy

Who are the people and organization who are actively buying our elected representatives on the issue of health care reform? A visibly angrier than usual Keith Olberman calls them out, specifying the names and the obscene payments of cash:

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Fat and salt and sugar and fat and salt and . . .

Fat and salt and sugar and fat and salt and . . .

Amy Goodman recently interviewed David Kessler, who used to be Commissioner of the FDA under Bush I and Bill Clinton. He has really turned up the heat on the unhealthy food industry, and it is a huge industry. It’s repeat clients also frequent hospitals in droves, as reported by DemocracyNow:

[A] new report from the Centers for Disease Control and Prevention warns that the direct medical costs of obesity total about $147 billion a year. That amounts to nine percent of all US medical costs. It’s also over $50 billion more than the annual spending on cancer.

The problem is that we have these innate and insatiable cravings for salt and sugar and fat.

Fat and sugar, fat and salt, fat, sugar, and salt stimulate us to eat more and more. Does the food industry understand the inputs? Absolutely. They understand that fat, sugar and salt stimulate us, and they understand the outputs. They understand we keep on coming back for more and more, as Kessler explains:

Have they understood the neuroscience? Have they understood how fat and sugar work? I don’t think so. But we now have that science. But what’s important is the fact that they have figured out—they’ve learned it experientially—what works, and they construct food to stimulate us to eat more . . .

What has the food industry done? They’ve taken fat, sugar and salt, they’ve put it on every corner. They’ve made it available 24/7. They’ve made it socially acceptable to eat at any time. They’ve added the emotional gloss of advertising. Look at an ad; you’ll love it, you’ll want it. They’ve made food into entertainment. We’re living, in fact, in a food carnival.

But how much fat, sugar and salt can you possibly pump into food? More than you can imagine. Kessler explains the formula:

So, take an appetizer in a modern American restaurant. Take buffalo wings. What are they? You take the fatty part of the chicken, fried usually in the manufacturing plant first. That loads about 30, 40 percent fat. Fry it again in the kitchen of the restaurant. That loads more fat. That red spicy sauce? What is it? Fat and sugar. That white creamy sauce on the side? Fat and salt. What are we eating? Fat on fat on fat on fat on sugar on fat and salt.

But aren’t the obese people the real problem? Why blame the terribly unhealthy food industry (Did you like this framing of the question)? Yes, people need to get disciplined about the way they eat. No doubt. But when 2/3 of American adults are overweight, it’s time to assume that the artery-clogging food manufacturers of American are immorally creating an environment ubiquitously filled with toxic supersized portions. In short, I fully support new Congressional legislation would provide up to $10 billion a year for a prevention and public health investment fund that would include a focus on curbing obesity.

See this related post on the effect of growing portion sizes.

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Rep. Anthony Weiner: Why do we need health insurers at all?

New York Representative Anthony Weiner is my new hero. It’s clearly time for a single payor system and it appears that progressives are finally getting the courage to speak up for it. There is no rationality in a system that syphons health care dollars off as profits to big insurance corporations. Kudos to Rachel Maddow for prominently featuring this issue.