Monday, June 29, 2009

Health Care?????

I mentioned I would likely write about this subject more than once. My friend, mentioned in the first article, lost half his foot. We do not know at this time if that is where it will stop.

The antibiotics the insurance company approved, as opposed to what the doctor recommended, did not work. The delay created, again by the health insurance company, in second guessing the doctor was not wise. The prescribed drug ordered from Canada did not arrive promptly due to directives to scrutinize all such orders at the US border.

This antibiotic resistant bone-eating bacteria is often picked up in hospitals and it can be fatal. Left untreated for too long it can reside in multiple places in the body other than the original site.

There is a great debate going on in Washington about health care. First I want to say health care insurance is a misnomer. It is medical insurance. They currently pay for nothing that can be called healthy. Even the routine exams they advocate we all have are not totally paid for. All deductibles are up front which, in this economy, deters people from going to the doctor to maintain health. Most insurance companies do not pay for things that would keep us healthy like exercise programs or vitamins or massage even when a prior health problem would advocate such maintenance programs.

Another total red herring in this whole medical insurance debate is that we would lose our freedom of choice. We have no choice currently. The insurance providers, as in my friend's case, call all the shots. Doctors and hospitals, to reduce administrative costs related to insurance, often hedge their bets on treatments from what they might think will work to what they know the insurance company will pay for.

And three, the United States no longer has the best medical care in the world. More and more people are opting for medical tourism. At some point in my future I may need shoulder surgery. I plan to go to Thailand. A $40,000 procedure here is only $8,000 there including the hotel before and after surgery. And they are considered cutting edge (no pun intended) with use of shark cartilage to replace damaged tissues. I want an insurance policy that will pay their 80% of that but then my co-pay on the cost here would be about the same. I only need to come up with the air fare if insurance will pick up post op physical therapy.

There is a lot of mud slinging going on around this whole issue. The waters have been muddied with half-truths and out right lies by he opponents. That if we go with any plan the government comes up with we will have to wait forever for treatment like Canadian and United Kingdom citizens do. In this day of Internet friendships around the world those lies can be easily put to bed if you are half-way computer literate.

Meanwhile a growing number of American citizens cannot afford medical insurance and their unpaid bills raise the costs of the treatments the rest receive. We have some of the highest medical costs in the world and they have risen way more than the standard rate of inflation. Something has to be done. We need health care which is based on what the doctor, and not the insurance company, feels is appropriate. And it needs to be at a price that does not lead us to bankruptcy.

Wednesday, June 24, 2009

OMG - Who Would Believe This?

If you wrote a novel with this plot your agent would send it back as "too unbelievable." You maybe could get a film maker interested. After all they come up with movies like Terminator.

Seems that rising GOP Presidential hopeful in 2012, Gov. Sanford, is not missing from a hike on the Appalachian Trail. He flew to Argentina to be with his new lover.
He has been having an extramarital affair with a "dear dear friend" in Argentina. The affair, he said, began "very innocently" but blossomed into "something much more than that."

Something much more than that is one of those phrases men use when they get caught with their pants down around their ankles. He admitted to lying to his staff and obviously lying to his wife today. He has promised to resign as chairman of the Republican Governor's Association and it does not look like Ensign, the Governor of Nevada, will be picked to fill the position.

I have just one question: Aren't the Republicans what we used to call the moral majority? Yes, they are a minority now, but I don't think the Christian Right can endorse this sort of behavior. Though frankly I have know a few Baptist ministers to screw around. And a couple leaders of the Promise Keepers in Colorado Springs have not kept promises.

My ex-husband and I used to have this catch phrase we would repeat about news like this: "What were they thinking?" Clearly he wasn't; Proving once again men, even Republican ones, can only think with one head at a time.

Sorry, adult content. But why do they call it adult when they are obviously acting like spoiled little boys?

Friday, June 19, 2009

And We Should Believe This Why?

Iran’s supreme leader, Ayatollah Ali Khamenei, angrily warned opposition leaders Friday to stay off the streets and denied opposition claims that last week’s disputed election was rigged.

Meanwhile on Twitter and Iran Blogs they are saying that the election was rigged and demonstrators are being jailed an abused. If this election was so fair and the opposition is being treated fairly why aren't legitimate western news sources allowed out of their hotel rooms to cover this victory for democracy?

Certainly if the Ayatollah is correct the election will stand the test of scrutiny the world will hold it to. I frankly have my doubts but then I have lived through two bogus elections of GW Bush. And I can understand the anger of the people of Iran to have a Supreme leader (in our case the Supreme Court) declare what we in our hearts and minds knew was wrong.

From the outside looking in obliquely, since they are allowing no direct viewing, they made a few huge mistakes. First was declaring victory within hours in a country that counts its votes by hand. Second was in underestimating the power of the "informal media" out there these days with their cellphones and text messages to Twitter.

And naturally the ousted formal press is upset and going with Twitter for its source on what is happening inside Iran. Who knows what we will see when the dust settles around this disputed democratic election. One thing we will know for sure: Never underestimate the power of the people to get their story out these days. They will even beg Twitter to not shut down for routine maintenance of their site.

Who would have believed this: Twitter is the new Radio Free Europe in the Middle East.

Monday, June 15, 2009

The Power of Medical Insurance Companies

As some of you are aware a friend of mine has been dealing with a wound on his big toe that will not heal. In the last four months his doctors have been using every antibiotic by mouth and IV to stop the spread of a bone infection likely gotten because of a stay in the hospital.

In the last couple of weeks they have begun to discuss amputation of at least the big toe and possibly to below the knee. In a last ditch effort to save parts of himself he made an appointment with another specialist in Santa Fe. That doctor wants to try one more round of antibiotics before hacking.

The cocktail of three antibiotics (Marc is way beyond the using one at a time stage) includes Zyvox which is used primarily on diabetics with infections. Here in the states it costs $2220 without shipping (it is so pricey none of the local pharmacies carry it).

That it needed to be shipped got Marc's wife looking on the Internet and she found Zyvox made by the same company and in the same dose as prescribed at a Canadian on-line pharmacy for $220. Overnight shipping brings it to $250 which is less than the co-pay would be here in the United States if Marc's insurance company would approve the drug. No it is too expensive.

The interesting part of their argument that it is too expensive is that they have already approved the amputation. Which got me interested on what that would cost. I found an interesting website on Below the Knee Amputations. I warn you that it can be a bit graphic.

The main surgery is likely to be in the $100,000 to $200,000 category. Artificial limb in the $12,000 to $20,000 range without bells and whistles. Then there is the after surgery wound care and physical therapy and pain management and emotional counselling, etc. Yearly medical treatment costs for an amputee in 2003 prices is around $100,000. I won't go into the rise in medical costs since 2003 in detail. One estimate said almost 200%.

I have a nurse acquaintence that believes medical costs are supported by the insurance companies. Nobody thinks that these insane prices will have to be paid by an individual but almost 40% of our population here in the United States is uninsured these days. And the rising cost of insurance premiums means that less and less employers provide health insurance. And health care costs for major manufacturing companies here is seen as the single reason they cannot compete with companies abroad.

And yet the Republicans are opposed to any reform of health care here. And so is the insurance lobby. They, and not the medical professionals and facilities, are what is really endangered with a reform of our current system. Some 70% of the citizens in the United States want a single payer plan. And the statistic is higher among doctors that have to have staff simply to deal with our complex insurance system.

Taking just the example of my friend Marc I am appalled. A clerk at this doctor's office has been in persistent back and forth communication with his insurance company to try and get this prescription approved. The insurance company (the ones without a medical degree in this debate) have proposed an alternative cheaper drug chosen just because he has not been on it before. And while the debate has gone on this last ditch effort to save his leg has been delayed as the infection progressed.

If you do things outside what the insurance company recommends they can disallow everything past that. In other words they can get out of paying for the amputation if Marc goes against their advice (but within medical advice) and takes the Zyvox. Another horrid statistic is that one out of three below knee amputees die within in three years. I cannot wonder if that is what the insurance company is hoping for.

Note: I don't think this is going to be my last article on insurance companies and the "best in the world" US health care system. While doing my research I found out that circulation impairment can be the number one cause of wounds that don't heal and unless that is fixed the chances of a successful healing of the amputation is doubtful. Marc has yet to have a circulation test.

Thursday, June 11, 2009

I Can Get Fired Up on This Subject

In my last blog I mentioned an inability to find a topic I can really get fired up about in a blog since G. W. is no longer around to kick. Since then I have had two hot topics fall in my lap. One of them I am still researching. I was Googling articles on the FDA when this gem popped up from a New York Times headline:

The Senate voted overwhelmingly Wednesday to impose federal
regulation on cigarettes and other forms of tobacco, passing a landmark bill to empower the Food and Drug Administration to control products that eventually kill half their regular users.

I will suppress all urges to say, "What took you so long?" because I know the strong tobacco lobby pays for a lot of congressional seats and junkets and campaigns, etc. And even this historic bill has the hand of big tobacco in the framing: The FDA can regulate but not ban.

And let us put this in realistic perspective. The FDA does not have budget or manpower to regulate those substances they are already put in control of. This is the agency that cannot stop fake protein of a poisonous nature showing up in your baby and pet food made in China.

Hopefully they will pay some attention to the additives that go into your cigarette and other tobacco products; additives that do not have to be listed on the packaging because they are trade secrets. Most are flavorings like chocolate and cherry syrup to give a normally sage tasting leaf flavor. But the industry commonly uses ingredients like ammonia to rush the nicotine in tobacco to your blood stream (also used in freebasing crack cocaine I am told) to increase craving. Or a drying agent that stops the breathing of new workers on the assembly line or visitors as the wet tobacco passes through the ovens. Maybe they can pay attention to the fact that to increase usage of their product big tobacco ups the nicotine content by 14%. Nicotine, by the way, is a metabolic poison not unlike that fake protein used by China in baby formula only deadlier.

What other product that kills 50% of its users, not to mention their families from second hand smoke, would be allowed to stay on the market with or without regulation. Sorry, Congress, I think this is too little and too late.

Tuesday, June 9, 2009

Tripping Through the News Lightly

I did not think I would ever say it but I miss G.W. There was never a question about what to write about in this blog when he was around. And Cheney, currently making the rounds of talking heads, with his revisionist history just irritates me so much that I would not be able to write reasonably.

So this morning I was scanning articles of interest on several on line news outlets and being horridly bored. More Saturday night quarterbacking of President Obama's economic stimulus plan. Boring. Ever notice that nobody knows how to solve something until someone steps in and presents a plan? Hey, we have never been here before and it does not do to cry, "He's wrong." How do you know?

And I am bored with failing auto companies. Though it looks like ten banks are asking permission to pay back the tarp funds. Isn't that what they were suppose to do? They keep finding more Air France bodies but nobody has explained where from came the wreckage first discovered in the supposed crash site but later proved to not be from flight 447. Anyone missing another plane or ship?

I soon found myself on the BBC - Earth News site. Seems they have discovered that chimpanzees remember the exact location of their favorite fruit trees. Their spatial memory is so precise that they can find a single tree among more than 12,000 others within a patch of forest, and also recall how productive each tree is, and decide to travel further to eat from those they know will yield the most fruit. If researchers discover which gene in our DNA determines this ability I think it ought to be implanted into the human male brain.

Researchers now think that our growing dependence on GPS devices is handicapping our own ability to know where we are or even follow directions. The program them with female voices because more men rely on them than women. BTW the GPS devices installed in all new automobiles just off the lot these days are not just for the drivers. They also help the repossession crews locate and take back the car if you fall behind on payments

Another Brave New World sort of thing is that they have developed a microwave device that can scan people for guns from a distance. I assume it will replace those metal detectors we have to walk through or will they use it on the streets to just routinely microwave us? What, pray tell, will be the long term effects of repeated exposure to microwaves on the human body?

When I was a kid every shoe store or department had one of those xray machines to see if your toes were being cramped by the shoes. We loved them and abused them whileour siblings were getting fitted for their new shoes. One day the machines vanished. Seems they were melting kids foot bones or so the rumor had it. That was before CNN and inquiring minds must know.

Anyway I emerged from today's news with a new respect for Chimps and further doubts about the human race. If we kill ourselves off do you suppose evolution will begin anew? If it does lets not lose that mapping gene.

Wednesday, June 3, 2009

Black Boxes

My masthead here (old newspaper term) says this blog is about political issues. So maybe discussing black boxes, which are in fact orange, is not political and belongs on Sidetracked Charley instead.

But with the loss of an Air France passenger jet in extremely deep waters putting the recovery of the black boxes, which are in fact orange, in severe doubt it raised questions as to why they don't float? Or better yet given the technology and the many communication satellites circling our globe why they don't emergency up-link data when something significant happens like sudden lost of altitude.

There are two black boxes in every commercial aircraft. One records communications in the cockpit like, "oh, shit." And the other records key flight instruments and controls like flaps and hydraulics, etc. In this country the FAA mandates these devices to insure passenger safety by careful analysis of what went wrong in a crash. In the recent years there has been more and more question about the safety of an aging fleet of commercial aircraft and the degree to which the FAA has given passes to already financially strapped airlines.

And evidently the Federal Aviation Administration, its budget cut to the bone by 'smaller government' Republican administration, hasn't the manpower to perform all inspections required. Add to this the aviation lobby (right in there with the big boys of tobacco, alcohol, pharmaceuticals, NRA) which whines every time it has to fix or upgrade something to meet safety standards, and it is highly possible the technology for better recording and transmission of flight data in an emergency, or just ejector mechanisms and floatation devices does exist and airlines have fought it as too expense to upgrade their fleets.

Obama has promised to curtail the influence of lobbiests in the United States. I think he ought to look first at the lobby efforts that diminish the safety of the public. Prescription drugs, alcohol, and cigarettes need to be reined in. But also automotive companies, airlines, and communications. And after we are finished with the safety issues let us go on to rates and throw in utility companies.

But we should start with those black boxes. Why don't they float?