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POPSBarbara Ehrenreich: The Swine Flu Vaccine Screw-up More: According to Health and Human Services Secretary Kathleen Sebelius, the government was misled by these companies, which failed to report manufacturing delays as they arose. Her department, she says, was "relying on the manufacturers to give us their numbers, and as soon as we got numbers we put them out to the public. It does appear now that those numbers were overly rosy." If, in fact, there's a political parable here, it's about Big Government's sweetly trusting reliance on Big Business to safeguard the public health: Let the private insurance companies manage health financing; let profit-making hospital chains deliver health care; let Big Pharma provide safe and affordable medications. As it happens, though, all these entities have a priority that regularly overrides the public's health, and that is, of course, profit…
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POPSThe Quandary With Mammograms: Get a Screening, or Just Skip It?
More: Some researchers estimate that as many as one-third of cancers picked up by screening would not be fatal even if left untreated. But right now, nobody knows which ones. So what are women supposed to do? …Hoping to make sense of it all, I consulted several experts. All said mammograms were still important — after all, breast cancer kills 40,000 women a year in this country — but they differed about who really needed them and how often. All agreed that research was badly needed to figure out how to tell dangerous tumors from the so-called indolent ones… Dr. Formenti said the emphasis on screening by groups like the cancer society might have misled the public into thinking that screening could prevent cancer. “It’s a giant misconception,” she said. “…I have to confess that I’m happy if the public gets offended or infuriated” by the debate…"I want taxpayers to say: ‘You have no clarity. Study it. Stop telling us you are a good girl if you get a mammogram.’ ”
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POPSIt shakes a village: What thousands of individual economic crises mean for an entire community More: Through the Marin Housing Authority, Fatooh discovered three affordable housing complexes accepting applications -- then discovered a waiting list of three years. She phoned agency after agency, with no luck. Finally someone told her she'd have a better chance getting placed if she and the family spent three months living at a campsite. Meanwhile her repossessed house in Cazadero sits empty, she says. …The TV news reminds us every night: We're in a recession. But often the camera zooms in too tight: the single family facing eviction, the single worker laid off at the plant, the single patient unable to pay for cancer treatments. The panorama of such cases remains hazy: What does joblessness, foreclosure or lack of healthcare mean for entire communities? What happens to town after town of people like Kassy Fatooh? How does a multiplicity of stories like hers tear at the patchwork of agencies and services meant to hold our communities intact?
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POPSThe "Vision Chart Effect" in health reporting If a person is overweight, often that's the only thing a doctor will focus on. Your knees hurt? It's because you're fat! Your skin is breaking out? It's because you're fat! You have a cavity in a tooth? It's because you're fat! You're getting headaches? It's because you're fat! For many people, this eventually discourages them from going to see the doctor, even when they have a possibly-serious health problem. Like my mother. She'd spent a lifetime being told by doctors that all her problems were because she was fat. So when she felt a lump in her breast, she latched on to the (false) conventional wisdom that "if it hurts, it's not malignant." By the time she saw a doctor about it, it was stage 4 and had metastasized to her lymph nodes. She died at age 53. She was the smartest, funniest, most loving, toughest, most dynamic woman I've ever known. I miss her terribly every day. And she died as a result of fat prejudice. Yeah, I take this personally.
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POPSData-mining medical records could predict domestic violence More: Using the new system, the researchers were able to predict abuse an average of two years before the doctor made the diagnosis. Presumably, the computer is picking up signs of ongoing maltreatment the patient hasn’t yet revealed. The researchers also speculate that, in principle, some subtle signal could precede direct abuse. One surprise finding that could be relevant… is that infections turned out to be strongly linked to abuse. That might suggest worsening hygiene in the family or increased psychological stress, possible omens of abuse. But at this point, it is anybody’s guess whether true predictions are possible. Predictions or not, with the current model, fewer than 20 percent of the patients flagged as high-risk cases turned out to have a diagnosis of abuse. Part of the problem may be that the system is only as good as the data it was based on. And as Emory University’s Houry points out, that data isn’t up to speed when it comes to diagnosing abuse.
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POPSWe need national health care because lack of insurance kills people More: Want to know something even better? The constitution we shoved down the throat of Iraq, requires healthcare for everyone . Pretty good inn't? George Bush, and his neo-con cabal (the folks who believed the parades would last, even after the random raids and the abuductions started) insisted that First: Every citizen has the right to health care. The State shall maintain public health and provide the means of prevention and treatment by building different types of hospitals and health institutions. Second: Individuals and entities have the right to build hospitals, clinics,or private health care centers under the supervision of the State, and this shall be regulated by law. But here, in the wealthiest nation on the planet, with (we are assured) the "best healthcare in the world,"people die from the flu, because they can
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POPSThe Alternative Medicine Cabinet: Arnica for Pain Relief More: The Risks: Arnica gels or creams can cause allergic reactions in some people, but it is generally safe when used topically. However, it should never be rubbed on broken or damaged skin, and it should only be ingested when in a heavily diluted, homeopathic form.
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POPSDid bad care spur a mother to kill her disabled daughter? More: She wrote that the aides bathed Yvette "like a car," with cold water at times to punish her. When Yvette would scream, the aides would turn the hot water back on before the nurse in charge could arrive, according to the letter. "There's much more but you can ask my family. "... They can tell you. I can't go on like this. She has been begging me to end it for two years," Diana Harden wrote. "My health is failing and I don't want to leave her alone."… Because she was partially paralyzed, Yvette Harden could get around only with a wheelchair. But staff took away the motorized chair after Harden broke a glass patio door and bent the metal on a gazebo fixture in July 2008. She was given a manual chair that she had to be strapped into because it was too small and made the pain in her legs and back worse, according to Department of Public Health records. She told her mother, "I want to die; I don't want to live without my wheelchair…"
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POPSTo Err is Human: Institute of Medicine report on reducing preventable medical errors Sadly, it's now 10 years after its release, and most of its recommendations have not been heeded. More: To Err Is Human asserts that the problem is not bad people in health care--it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocates--as well as patients themselves.
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POPSWhy we SHOULD give illegal immigrants health care coverage What's more important? Posturing over "no coverage for illegals!!!" or actually saving money and improving health care for all? More: What's more, employers currently have a clear economic incentive to hire undocumented immigrants: they don't require coverage. A plan that mandates insurance for native workers but not their illegal counterparts actually makes life harder on the blue-collar Americans competing for jobs (and railing against immigrants) because it means that hiring them will cost more than hiring a recent transplant from Mexico City…. But despite the potential economic upside, the right shouldn't stress: America won't insure its illegal immigrants any time soon. "The hard thing here is that the current state of perception on immigration is eroding our sense of social solidarity… People simply don't want money going to people on the other side of the tracks."
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POPSHow Big Pharma pushed a more-expensive, no-more-effective drug More: Lexapro had $2.3 billion in sales in 2008 even though generic versions of Celexa and every other drug in the class sell for a fraction of Lexapro’s price. For example, a month’s supply of 5-milligram tablets of Lexapro costs $87.99 at drugstore.com, compared to $14.99 for a month’s supply of a generic version of Prozac. Forest has recently been raising the price of Lexapro to make up for a decline in its use… It is impossible to unpack all of the reasons for these prescriptions, but some industry critics say one reason could be the money doctors make from Forest. Psychiatrists make more money from drug makers than any other medical specialty, according to analyses of payment data. And Forest gives more money and food to doctors than many of its far larger rivals… Forest’s payments to doctors in 2008 were surpassed only by those of Eli Lilly, Pfizer, Novartis and Merck — companies with annual sales that are five to 10 times larger than Forest’s.
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POPSWhy a hospital is a bad place to have to make decisions More: You're standing at the chaotic hub of the hospital floor, with people being as helpful as they can -- really and truly -- while they are also dealing with the usual countless crises and being short staffed. It's an uncomfortable space.… And, every minute or two, there's this guy in some room somewhere, screaming for help which he may or may not desperately need, which may or may not be possible to give him -- but which isn't coming any time soon. And every human being in earshot, including you, is ignoring this. You aren't even wondering why no one is helping the poor guy. After all, he's not the one guy in the hospital you've come to see. You're used to it by now -- the screaming, the beeping, the feeling like you're in the middle of Grand Central Station at rush hour. Human beings can get used to anything. Anything. But, that doesn't mean it doesn't affect us.
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POPSWhat would the opposite of a Living Will look like? If you don't do any preplanning to put a living will or other advance directive into place, what happens when you're incapacitated and unable to make decisions for yourself? Your family will have to. This clip gives an idea of a few of the questions they'll have to face.
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POPSThe emergent danger to personal liberty More: (Unfortunately, the use of government as a tool to enhance liberty is anathema to conservatives, focused as they are on the eighteenth-century threat alone.) If we lose this health insurance battle—or even if we win it—I’m still a progressive. I’ll still be pushing to right the balance. I expect to work on it all my life. …3. I worked for a while with a sister of one of the McLibel defendants. I know how bad it can get. Click through to read the whole thing, including footnotes 1 & 2.
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POPSReforming health care is fiscally conservative More: Real conservatives should point out that the current proposals are not tough enough on costs - and criticize Obama for that, not for fantasies like a communist takeover or euthanasia program for special needs kids. The Romney-Obama model will require fiscal boundaries to healthcare provision and this will mean a trade-off that will be hard to postpone much longer. We'll get less innovation, and probably some rationing at some point. But that is already happening - the rationing is done by insurance companies. One final thing: most Americans do not want people dying in the streets. If you have guaranteed emergency room care for the uninsured at public expense, you have already effectively socialized medicine. It makes no sense not to bring these people into the insurance system, and to offer less expensive, long-term preventive healthcare. To insist that ideology stand in the way of this piece of compassionate common sense is irresponsible.
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POPSAndrew Sullivan: Where this far-right rage is coming from More: If that is what you really believe - that people in cities or suburbs, that minorities, that gays, that blacks and Hispanics are not part of "real America" - then of course, you are angry. You believe a fake America has taken over. You cannot understand this. So you start believing that we have a fascist/communist dictatorship, that there was some fraud allowing a non-citizen to become president, that the government is about to "take over" all healthcare provision ... and on and on. And no one is left in the GOP to challenge this, to calm it down, to present practical alternatives to the obvious crushing problems the country and the private sector have in paying for increasingly costly healthcare.
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POPSWhat do I want in a health care system? More (the footnotes):† Barring sudden death at a young age, we are all, at best, currently healthy rather than healthy. ‡ I am deeply ashamed of how many of my fellow countrymen have a problem with this, even if the risk pool is wide enough to make it a relatively low amount of subsidy per person. It also ignores the realities of childhood poverty and contagious disease, both of which have impacts that cross the "I've got mine" line.
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POPSBy modern conservative standards, Winston Churchill was a Bolshevik More: As a lifelong conservative with a strong dedication to enterprise and merit (and a host of less admirable right-wing prejudices), Churchill would have bristled at anyone who dared to describe him as a socialist. Why then did he promote and protect the NHS? Partly out of political expediency, no doubt, but also because he felt an ethical obligation that seems not to trouble the contemporary conservatives who profess to admire him.… Whatever the marvels and defects of the NHS may be – and most experts agree that it does a superb job despite inadequate funding -- its importance for the debate over American health care reform may be moral rather than practical. Imagine what kind of country we would inhabit if those who claim to represent conservatism in America possessed even a small measure of the human compassion and political decency of Churchill at his best. It is a standard that they do not even attempt to achieve these days.
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POPSNew website shows low-income Californians how to reduce medical costs More: Since the country’s first Hospital Fair Pricing Act took effect more than two years ago—Assembly Bill 774––California hospitals are required to offer fee discounts and are also capped on what they charge patients who typically face their highest fees: the uninsured.… many hospitals have complied with California law—“Some are doing it well, some are not”—but two nagging problems continue. First, rural hospitals, or those not affiliated with large chains, frequently don’t mention the mandated discounts. Second, obtaining the discounts can be difficult. The Web site was created “not to bash hospitals,” but to offer patients their options under the law.… For patients, medical bills are causing rising debt loads and even medical bankruptcy. Consumers who buy catastrophic health-insurance plans and limited “junk” insurance often find that their plans have strict limitations, which often saddle them with enormous debt….
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POPSLowering health care costs not tied to tort reform More: the second travesty is that the $17.7 million — which he could surely use over the many remaining years of his life — was cut by more than half by Texas law. The award included $6.72 million in economic damages and $11 million for pain and suffering. But the $11 million immediately was reduced to $250,000. Because that’s all Texas law says he can have. Did I mention that health care costs in Texas keep going up, anyway? At age 53, Mr. Fitzgerald can expect another 21 years of life . $250,000 divided by 21 years equals a little less than $12,000 a year. Anyone want to volunteer to have BOTH arms and BOTH legs amputated as the result of somebody else's carelessness and incompentence, in exchange for $12,000 a year? Anyone consider that a reasonable trade-off? Didn't think so...
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POPSWhy Obama's popularity rating is not that big a deal More: Where will the primary challenge to Obama come from? Would any significant element of the Democratic Party be likely to lend support to such a rebellion? He won by a larger margin than any Democrat since LBJ, and mobilized electoral blocs that are key to the future of the party. Where is the ascendant trend for the GOP, when they are the ones losing the "growing" constituencies -- young people, Latinos and the West -- and they are the ones whose policies created the mess Obama inherited? …As to the economy, everyone's guess is as good as the next person's. Approval ratings won't matter much if we never get out of the current bind, as even Obama himself in a moment of surprising honesty has admitted. But if things get even moderately better, it is hard to imagine, short of scandal or war, that this nation will turn its back on the choice for change it so decisively made last November.
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POPSMaking lives better by recycling durable medical equipment More: A man has come to pick up a cane and commode for his disabled wife. He knows there is no charge for the items, but he pledges to make a future donation as he walks away, as soon as he can, when "things get better some day." A woman arrives and hopes to find a walker for a friend who "can't stand on her own two feet anymore." Meanwhile, an elderly woman approaches with a large floor mat balanced on the handlebars of her own walker. Susan runs up to greet her — she is a friend and regular visitor who routinely searches the neighborhood for items that Home Cares might use. A volunteer named Wayne offers to assist me, and I discover through conversation that he's an expert mechanic available to help with wheelchair problems. A young man in a baseball cap arrives — there, weekly as usual, with his pick-up truck brimming with donated medical equipment and supplies.
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