Way Overdue

Once again I'm way overdue in posting something to the old blog. Sorry about that -- there's just WAY too much stuff to write about to fit in one post, so I'll shotgun a few posts with my top thoughts.

Let's start with the syphilitic elephant in the room: healthcare. An innocent girl recently died because nobody would assume the financial burden of performing a liver transplant and committing to the long-term care of a transplant recipient. Most are blaming Cigna for her death, and that's appropriate because insurers are nothing more than parasites on the healthcare monster. However, I've heard at least one commenter ask why the hospital (UCLA, if I remember correctly) couldn't proceed with the operation and fight with Cigna over the costs later.

The very discussion of who should pay and how illustrates the problem with the US healthcare system in general. We're spending our time worrying about who's profiting or losing money while the clock ticks on someone's life. Healthcare and corporate profit/loss have no business being in the same discussion. You end up with criminal decisions like whether it's cheaper to redesign the Ford Pinto or pay the damages caused when they explode.

As I've said before, the best solution is to spread the risk of loss equally among the entire population rather than throw us into a feeding frenzy of profit-hungry corporations. We've got a model (medicare) that works. Let's spend our energy expanding that program and fixing its flaws instead of continuing to let Americans die so that some CEO can afford to upgrade his BMW.

Golden (??!!) Triangle, Texas

Yay.

I'm in sunny Port Arthur, Texas. Its only claim to fame is that this is where Janis Joplin hailed from. There's even a museum for her, but I don't think we'll make it over there this trip. Sorry, Janis, it's just not Graceland.

An AP article published today (http://www.usatoday.com/money/industries/health/2007-09-09-risk-penalties_N.htm?csp=34) discusses the trend of companies charging their employees for failing certain health metrics. There was an opinion piece by Dr. Arthur Caplan on the MSNBC website a few weeks ago (http://www.msnbc.msn.com/id/20181526/) that really lit a fire under me to oppose this trend. Please go read it yourself, but to summarize it encourages employees to be thoughtful when weighing discounts (or penalties) offered (or threatened) by employers against the value of your personal privacy. The MSNBC article pointed out that it's not an unreasonable extension of the "increasing insurance costs" logic to charge employees extra if they engage in "risky" behavior. Like SCUBA diving. No, thanks. You can take your money and shove it. I'll keep my private self private.

You've got to check out the archive of the Australian TV show The Chaser's War on Everything. These are the guys who just recently created a "motorcade" with Canadian flags and got within 10 meters of the Shrub's hotel in Sydney during the APEC conference. And one of the passengers was dressed as Osama bin Laden!

From the Chaser's War website:

"If you've got a tip off or a gripe, don't tell MediaWatch they'll just make a legitimate point on your behalf. That may give you some satisfaction, but it won't be as satisfying, or as fun, as getting the Chaser team to wreak some revenge for you."

You can find the show at http://abc.net.au/tv/chaser/war/ . There's a year or so of back episodes that you can download or stream to your computer. Bloody hilarious! A lot of the gags relate to Aussie politics, but just roll with it and pretend you understand until they get on to another topic. Thanks to Lesley for pointing me to that archive.

More on National Healthcare

"Of all the forms of inequality, injustice in health care is the most shocking and inhumane."
Dr. Martin Luther King, Jr.

At least someone's hard at work on solving the healthcare problem. California is chewing on a pro-insurance healthcare "reform" bill that feeds the insurers, but the California Nurses Association and the National Nurses Organizing Committee are showing how bad that bill is. Please look at their website, guaranteedhealthcare.org, learn about the issues, and tell those who have been or want to be elected to office about how important healthcare is to our nation. Here's one to get you started:

Children's Mental Health, Social Decay, and Big Profits

The number of pre-adolescent children diagnosed with bipolar disorder has skyrocketed since the mid-1990s, according to a very sketchy Associated Press article today summarizing a study by Dr. Mark Olfson of Columbia University and the New York State Psychiatric Institute and partially funded by NIMH.

Throughout the mid 1990s the number of kids diagnosed with, and medicated for, ADHD also increased dramatically. One explanation was that the medical community (and society at large) had become more comfortable acknowledging the existence and validity of pathological psychiatric conditions. Another camp argued that parents who were unwilling to discipline unruly kids were jumping at the possibility that a pathological dysfunction was to blame, thus absolving them of the charge of failure to discipline.

I'm sure that there is some truth to both positions. The real question is what lies at the heart of the increase? By the title of my entry, I bet you can guess where I'm headed: Money. Always follow the money. My outrage this time was ignited by a recent episode of the Australian Broadcasting Company's Radio National program "Background Briefing" entitled "Mentally Ill Children." The transcript is here:

http://www.abc.net.au/rn/backgroundbriefing/stories/2007/2012718.htm#transcript

You can listen to the radio show by streaming or downloading the audio from the same page.

The obvious link between profits and psychiatry can be seen in the MASSIVE amount of money being thrown into advertising campaigns for "new" psychotropic drugs. The pharmaceutical industry is happy to validate any diagnosis that they can sell a "cure" for. If you want a disturbing example of the lengths to which big pharma will go to make money, do an internet search for "Neurontin," an anti-seizure drug that Pfizer Pharmaceuticals and its subsidiary Warner-Lambert manufactured. Although the FDA approved the use of Neurontin as an anti-siezure medication in 1993, Pfizer and its subsidiaries heavily marketed Neurontin to psychiatrists for a variety of unapproved ("off-label") uses. They pushed its use for bipolar disorder, ADD, migraines, drug/alcohol withdrawal, restless-leg syndrome, and even Lou Gehrig's disease, despite scientific studies showing it to be ineffective for these conditions. In 2004 Warner-Lambert pled guilty and paid more than $430 million to resolve criminal and civil charges that its off-label marketing of Neurontin was illegal and fraudulent. In addition, over 300 lawsuits were filed alleging that Neurontin contributed to suicidality in certain patients. More information on this case can be found here:

http://www.fda.gov/fdac/features/2004/404_wl.html

Parents of children that have been flagged by school counselors as problems can attest to another phenomenon: If a psychologist or psychiatrist diagnoses the child as having a coping disorder or other non-pathological condition, their insurance company is likely to refuse reimbursement or payment for treatment. However, they will reimburse healthcare providers if the condition is pathological and medication is prescribed. Since it's easier for a psychologist or psychiatrist to collect fees from an insurance company than from an individual, guess which alternative the professional is likely to choose: Follow the money.

Are we as a society becoming less tolerant of people that fall outside the "norms" of behavior? Wasn't Albert Einstein a poor student? I think he ended up OK even without Ritalin. Why are kids that don't want to conform to the expectations of the majority shunned as pariahs? I'm really worried that after generations of "fixing" kids who are different we will crush the creative spirits that make our life interesting. Fortunately, there are still parents who welcome this diversity of thought. I just hope our schools don't take on the role of thought police. Orwell's 1984 didn't just warn against a political hell, but a social one as well. We'd do well to heed his warning (though obviously we haven't).

Great Healthcare Analogy

I am an enthusiastic proponent of a national single-payer healthcare system, like a national medicare. The stats on medicare show it to be a much more cost-effective method of providing basic healthcare than our current hodgepodge of competing insurance companies and healthcare providers. It's no surprise that whenever I raise this issue with one of our indigenous conservatives, their knee-jerk reaction is always always ALWAYS! "socialized medicine -- bleah!" I'm not going to get into how a single-payer system is fundamentally different from socialized medicine. It's simple and you probably already understand it. If you don't, post a snide comment and I'll provide my quick summary.

Monday I read Paul Krugman's column in the NY Times that captured the cognitive dissonance that permeates the Republican position on healthcare reform.

You've heard the Republican talking points against a single-payer healthcare system: It should be left to the free market, I don't want my taxes paying to fix someone who smokes, If I work hard I get better medical care, etc.

What if you substituted K-12 education for healthcare? In order to be consistent with the Republican position on healthcare, I'd have to take the position that since I don't have kids, I shouldn't be required to subsidize the education of someone else's kids. I'd have to advocate creating an open market for education and abolishing public schools entirely. If I earn a lot of money, I should be able get my kids a first-rate education, and if you can't afford it you're simply not working hard enough and will have to settle for a low-budget school. The government shouldn't mandate education -- it should be a matter of individual responsibility. I simply can't agree with any part of that position. Just writing those few sentences made me throw up a little in my mouth.

Honestly, isn't access to healthcare a critical element of a nation's standard of living? (By the way, ours is slipping rapidly.) I know education is considered a key element, as is literacy. Why is access to education mandatory while Americans are thrown to the wolves when it comes to healthcare? If you are sick, you can't go to school, you can't work, and you become a burden to family; not to mention the economic impact when you can't afford to pay for the care you do receive.

Here's what Krugman says:

The truth is that there's no difference in principle between saying every American child is entitled to an education and saying every American child is entitled to adequate health care. It's just a matter of historical accident that we think of access to free K-12 education as a basic right, but consider having the government pay children's medical bills "welfare," with all the negative connotations that go with that term.

And conservative opposition to giving every child in this country access to health care is, in a fundamental sense, un-American.

Here's what I mean: The great majority of Americans believe that everyone is entitled to a chance to make the most of his or her life. Even conservatives usually claim to believe that.

But a child who doesn't receive adequate health care, like a child who doesn't receive an adequate education, doesn't have the same shot - he or she doesn't have the same chances in life as children who get both these things.

And insurance is crucial to receiving adequate health care. The reality is that the nine million children in America who don't have health insurance often have unmet medical or dental needs.

I scored a symbolic victory a while back in a debate with an ultra-conservative cow-orker. We were discussing the issue of the rising cost of healthcare (in the context of an MSNBC article about a woman who was bankrupted by cancer treatment costs in spite of having insurance), and how the problem lay in part with the marketing costs that insurance companies incur competing with one another. As the discussion reached a climax, he said "the bigger the pool of insured, the lower the cost to the insurance company." So, naturally, I suggested that if the pool consisted of the entire population of the US. . . .

That ended the conversation.

Please, God, let us throw them all out in 2008 and start the long, slow march back to sanity. Our standard of living should be IMPROVING, not DETERIORATING! If anyone's getting a free-ride in all this, it's the insurance companies, who have a DUTY to their stockholders to maximize profits. That profit mandate should be completely excised from access to healthcare in this country.