Puerto Rican Gov. Luis G. Fortuno is intent on making clear he’s a different kind of leader — the sort who pays for even his official expenses with his own credit card.
“I get reimbursed once they have checked that indeed my expenses were correct. And I think everybody should live like that,” said the photogenic 48-year-old, who eagerly whipped out a personal credit card and then jokingly challenged a reporter to poke through his wallet and verify there was no government-issued credit card to be found.
Given that the man he unseated as governor, Anibal Acevedo Vila, stood trial this year — but was found not guilty — of corruption charges, Mr. Fortuno has good reason to draw those distinctions.
Meeting with editors and reporters at The Washington Times, Mr. Fortuno sketched out ambitious plans to close his territory’s budget deficit and try to boost an economy that, he said, is lagging worse than the budget of any of the 50 states, including cutting 30 percent of political appointees’ jobs; reducing agency heads’ salaries; and changing policies on credit cards, cell phones and official vehicle use.
In the interview, he also pleaded for Congress to include Puerto Rico in any health care bill that passes and said he wants to see the island territory be allowed to vote on changing its status.
While serving two terms as Puerto Rico’s resident commissioner, its nonvoting delegate to Congress, Mr. Fortuno had a unique window into power politics in Washington. He said the city makes people lose touch.
“Living here, people think, is real life. It is not. Real life is so different out there,” he said. “A place that has three different newspapers just to cover what happens in the office that is the Capitol — that’s crazy. That is not real life.”
With nearly 4 million residents, Puerto Rico is near the middle of the pack of U.S. states in population. As a territory, though, the island does not have voting representation in Congress, and residents don’t pay federal income taxes on income earned there — but do pay other taxes, such as Social Security and Medicare.
On health care, Mr. Fortuno said he’s trying to work with Congress to include the territory in any plan that passes. Key lawmakers have said it’s too expensive to extend coverage to the island, but the governor says it’s a matter of fairness — particularly given the way the territory gives back in other areas, such as the second-highest participation in the U.S. armed forces.
“Anyone that feels that, why should Puerto Rico be included, they should ask every soldier, every man and woman in uniform, that has fought in every war since 1917, that question,” he said.
Some Democrats on the Senate Finance Committee have proposed an amendment that would extend access to health insurance exchanges to residents of the U.S. territories. The amendment was withdrawn until the Congressional Budget Office can figure how much it would cost, but backers said it’s a matter of basic fairness.
“How can we tell these citizens [in the U.S.] that their loved ones in the territories, even though they are American citizens, they won’t have access to the benefits?” asked Sen. Robert Menendez, New Jersey Democrat, when the panel discussed the bill last week.
The pressure is also on President Obama, who while campaigning in Puerto Rico during last year’s primaries said he would cover Puerto Rico in his health care plans.
Puerto Rican factories produce 13 of the top 20 prescription drugs used in the United States, Mr. Fortuno said, and while he was in town last week he met with the pharmaceutical manufacturers association and talked about having Puerto Rico covered.
But the governor says the bigger problem is that Puerto Rico’s long-term status is the key roadblock in addition to the current health care debate.
“Just fix it. Just decide what are we, and having clear rules will sort everything out,” he said.
He supports statehood but says his promise to voters was to push for a process that will let voters decide once and for all.
He’s asking Congress to pass a bill that would put up two referendums. The first would ask if Puerto Rico’s residents want to change their status, and the second, which would come later if voters say they want a change, would ask if voters want independence, free association with the U.S. or statehood.
Mr. Obama, during last year’s campaign, promised to support Puerto Rico’s efforts to have its status resolved. Mr. Fortuno said he hopes the White House will announce its support for the process once a bill passes the U.S. House — which the governor hopes could happen this year.
If Puerto Rico were to become a state, it would likely gain six seats in the U.S. House as well as two senators.
But Mr. Fortuno was less certain the residents of the District should see the same fate.
“It’s an interesting argument, and out of commity to my colleague from the District, I said, I support you in general, but I don’t think that’s the answer to it,” he said. He said the residents of the city could have representation in Maryland or Virginia as a solution short of statehood. “It has to be fixed. I feel there could be many ways to fix it.”
As for the territory’s economy, Mr. Fortuno says it went into recession three years before the United States as a whole. He’s battling poor credit ratings for Puerto Rico’s bonds and has had to impose what he calls temporary taxes on cigarettes and alcohol — though he says he’ll never support an income- or sales-tax increase.
Mr. Fortuno is a member of both the Republican Party and the New Progressive Party, which is one of two main parties that vie for political offices in Puerto Rico.
• Jennifer Haberkorn contributed to this article.
This article, Puerto Rico’s governor: Put us in health bill, was originally published in The Washington Times.
According to Wikipedia vultures are scavenging birds that feed mostly on the carcasses of dead animals. The word ‘vulture’ can also be used to describe residents who are in need of performing procedures that they have not done (enough) yet. As of today, I am one.
Of course he did not need the pleural tap today even though the GP had urged us to do it anyway. If I had decided to give him an appointment tomorrow it would have been fine and nothing bad would have happened to him, such as death. But I would not be there tomorrow. And pleural taps are high on my wanted list.
So I persuaded my supervisor to do it today. Why? Because it would be much more comfortable for the patient. What other reason could there be?
Besides me being the vulture praying on a patient only to perform the pleural tap…
I was going to read The Lost Symbol over the weekend but picked up T. R. Reid’s elegant indictment of health care in the U.S., The Healing of America (Penguin, 277 pp., $25.95). And I was hooked by the first sentence: “If Nikki White had been a resident of any other rich country, she would be alive today.”
Reid had his bad shoulder examined by doctors in other well-off democracies that included France, Germany, Great Britain, Japan and Canada. And he uses the results as a springboard for exposing flaws in arguments made by insurers and others against adopting practices that work overseas: “It’s all socialized medicine over there,” “They ration care with waiting lists and limited choice,” “Those systems are too foreign to work in the United States,” and more.
Until I can review The Healing of America, here’s a sample that involves excuses used by major insurers to reject claims:
“In other developed countries, insurers are required to pay every claim. But U.S. insurance companies deny about 30 percent of all claims, although some of these are eventually paid through an appeal process. The reasons cited for denying valid claims can be ingenious. When our family lived in Japan, the friendly adjusters at Prudential used to deny our claims for medical or dental care on the grounds that the bills we submitted were denominated in yen. Somebody at Prudential had determined that the Japanese yen was a foreign currency; that violated the rules. My company later switched our health insurance to Aetna, which employed a similar dodge: The adjuster said she couldn’t pay our claims because she couldn’t call the doctor’s office to verify the bills. It seems that Aetna had a phone system for its adjusters that didn’t allow international calls, so our claims had to be denied.
“The most maddening of all the profit-maximizing mechanisms in the U.S. health insurance industry is the practice known as ‘rescission,’ a legal term that means ‘We’re canceling your coverage.’ This occurs when an injured person who has been paying premiums for months or years has a serious accident or contracts a serious disease, which can mean serious bills for the insurance company to pay. At that point, the insurer’s Rescission Department digs through all the records, looking for a reason to cancel the sick person’s coverage. For example, Steven Hailey, a machinist in Cypress, California, paid his health insurance premium every month. Then he was hit by a truck. He was still being treated for his injuries when Blue Shield of California wrote to tell him that his coverage had been canceled because his weight was too high. He would have to pay the hospital bills himself – about $450,000 worth of bills.”
With the exception of Glenn Beck’s idiot return to 1950s science in an effort to bring back 1950s politics, I didn’t see any major calls for DDT to be brought back to fight West Nile Virus this summer, not even from the Hoover Institute.
DDT is particularly ill-adapted for fighting West Nile Virus. The mosquitoes that carry it are best fought in the larval stage, before they mature. DDT is exactly wrong for water applications.
But that didn’t stop people from asking for DDT as a barrier to WNV in the past. Is some intelligence taking hold now?
Did I miss the editorials? Maybe it was a better summer than it felt like.
(Still fighting stupidity on bedbugs — taking longer than it should.)
Dr. Mehmet Oz, the now famous TV personality, held a free medical clinic yesterday in Houston. Figures vary, but the Houston Chronical is placing the turn out at nearly 2,000; he had about 700 volunteers helping. That turnout is low, given that one in three people in the county lack health care insurance.
The stories of the people are important and illuminating. A video from the Chronicle, which I can’t seem to get on this blog, is here. It is really worth watching. As the Chronicle says:
Patients told stories of their barriers to health care: insurance loss after layoffs; premiums that became too high to pay; and being underinsured — having coverage, but not enough money to pay deductibles and co-payments.
Here’s another video taken before the clinic opened:
The opening placement of a commercial from Cadillac is too ironic.
The reference to Katrina is to the massive attempt by Houston and Galveston to take in the refugees from the hurricane that devastated New Orleans. Next to the Reliant Stadium, where Dr. Oz is, is the Astrodome, which provided shelter for the people of New Orleans who were originally in a stadium there.
Adopting treatment guidelines based on studies of what actually works is downright un-American.
By Sharon Begley, Newsweek
With concerns over health-care rationing reaching near-hysterical levels, imagine this scenario in an ER in the not-too-distant future. A 4-year-old suffers minor head trauma, perhaps from falling off a swing and hitting her head on the ground. She is dazed, and although she doesn’t lose consciousness her worried parents—visions of subdural hematomas andconcussion dancing in their own heads—rush her to the local emergency room, expecting that the doctors there will immediately do a CT scan.
Surprise. The ER intake nurse talks to the child, who is able to say her name and explain what happened in the playground. She did not lose consciousness, her mother (who witnessed the fall) tells the nurse. The little girl is not vomiting, the ER doctor determines that there are no signs of fracture of the base of her skull, and she does not have a severe headache. Verdict: no CT scan.
Are we about to reach a Malthusian limit to population growth?
By 2050 there may be about 35 per cent more people on Earth than there are today.
snip:
Nowadays it is understood that the key population-related issue is the destructive pressure human activity is exerting on our life-supportsystems, posing a growing threat to the sustainability of civilisation. Of course, this is not all because of human numbers; it also has to do with how much each of us consumes. That’s why, in our view, the US with its population of over 300 million and high per capita consumption should be seen as Earth’s most overpopulated nation. It is also why the emergence of “new consumers” constitutes a major additional assault on global life-support systems. Moreover, the 2.3 billion people likely to be added to the human population by 2050 will undermine those systems much more seriously than did the previous 2.3 billion, as each additional person will, on average, have to be supported by scarcer, lower-quality resources imposing ever greater environmental costs.
snip:
Yet many people still assume that humanity will easily manage to support more than 9 billion people in 2050 and beyond. Such confidence ignores some grim possibilities. There are only two ways by which population can stop increasing: a falling birth rate or rising death rates. We have already seen a rise in death rates in southern Africa and Russia, and there may well be further increases in death rate ahead, especially as disruption to the global climate increasingly destabilises agricultural systems. Even today, more than a billion people are going hungry.
Q. Is birth control permissible? Is this not in conflict with yaqeen in Allah Ta’ala?
A. Yes it is in conflict with Yaqeen in Allah Ta’ala. It displays Imaani deficiency. Birth control measures are not permissible. Birth control is a kuffaar method of interfering with the creation of Allah Ta’ala. Interference with any natural process of Allah Ta’ala is fraught with dire consequences in this world as well as in the Hereafter. A. Yes it is in conflict with Yaqeen in Allah Ta’ala. It displays Imaani deficiency. Birth control measures are not permissible. Birth control is a kuffaar method of interfering with the creation of Allah Ta’ala. Interference with any natural process of Allah Ta’ala is fraught with dire consequences in this world as well as in the Hereafter.
Workplace wellness doesn’t have to mean on-site gyms and in-house personal trainers. Small companies may be able to encourage healthy living and offer compelling perks to employees without spending a lot of money and time putting together a plan.
For a small company, the payoff can be big: Many employers report that healthier employees show up to work more often, are more productive, and visit the doctor less frequently. The payoff is also big for employees — and that should be your focus when implementing your program. The program is for them, not something you’re doing to them to reduce your insurance costs. Having the right attitude and getting everyone involved in a positive way is a good first step.
Here are five tips for small companies that want to get started with wellness at work.
Getting the hang of it, maybe just a little: that sentiment epitomizes my third day on the floor of 9 Long.
The day was hectic and scattered, especially since my patient was scheduled for Ultrasound of his new Kidney and Pancreas transplant first thing in the morning, which delayed my care for him. I would have jumped on performing my am assessment of him before he left, however the RN I was shadowing preferred that she introduce herself with me since she was primarily responsible for his care and my patient was her lowest priority since her other three patients included a liver transplant who had high pain needs, a kidney transplant who was ready for discharge, and a recent admit for pancreatitis. By time we made it into my patient’s room we had just enough time to pre-medicate him before he left for ultrasound.
While he was gone, I found myself supporting the high pain needs of the liver transplant patient who had trouble swallowing his medications and required attention to monitor his respirations due to a bolus administration of his IV dilaudid PCA. It was certainly a challenge and I loved the experience, however as I worked with Marilyn hop from room to room, providing teaching and care that was modified to each patient’s needs, I began to really appreciate how far I must go before I’ll be ready to fill this role independently without the benefit of two instructors and an RN to shadow.
After my patient had returned from his ultrasound, which took several hours later than we had expected, my assessment of him found that his blood pressure was a concerning vital sign. Of course his morning metoprolol was 3 hours late, however even after a couple of hours of administration Marilyn and I contacted the physician and had his dosage increased. Several hours later, the increased metoprolol had not had an affect on his BP. This may have been due to an earlier IV albumin administration, however we knew the BP had to come down in order to reduce the stress on the new kidney and so we consulted a physician who prescribed amlodipine.
After we received the prescription Marilyn and I stopped in my patient’s room to inform him that we received the order for amlodipine and would be administering it as soon as pharmacy updated the Pyxis profile, however as soon as my patient heard the name of the drug he adamantly stated that he would not under any circumstances take amlodipine because he had taken it in the past and it caused him to cough uncontrollably.
After some consult with the patient we learned that he had taken clonidine in the past without suffering the same reaction so we consulted the MD to change the order. However when we spoke with the MD there was a young resident standing by who expressed that “some patients just associate getting sick with a medication and blame the condition on the medication,” however the senior MD ignored this claim by the resident and promptly placed the order for clonidine.
This experience was valuable to enhance my appreciation of several factors of the patient centered model of care.
First, both Marilyn and I had first-hand witnessed the patient’s reaction and therefore we trusted and honored that he knew his own body’s reaction to the drug and knew that even if the order was maintained as amlodipine that he would refuse the drug; after all, he was an HIV positive on HART who was well versed in all of his daily medications and how they affected his condition.
Second, the resident MD was quick to treat the condition and not the patient, as displayed by his disregard of our communication of the patient’s complaint.
Finally, although the original MD practiced standard judgment in placing the original order, I recognize that there was a small systemic breakdown in this process; perhaps if there was a list of medications that the patient had reaction to other than simply allergies, we could have avoided this process altogether and made the correct order in the first place. Additionally, the process involved in consulting an MD for an order without having the MD actually see the patient causes a breakdown in the MD’s ability to provide patient-centered care.
I see once again that it is the nurse is the face and voice of the patient.
First of all, having served in the military, and worked in government bureaucracies at several levels, I have no trouble at all believing the government is loaded with people who would think nothing of killing most of us — right now. Having served as a policeman, I have no trouble believing way too many policemen would willingly carry out a round up of ordinary folks who simply don’t agree with government policies.
This flu and vaccine business is not just a US problem. The folks running this scheme don’t know any borders or boundaries. You can call them what you want, but certain seminal documents they have written indicate such things as their belief the world would be a better place if human population was reduced to 500,000. They say this in several places, with several different signatures, in places indicating it is the consensus of a great many global elite. So what is their track record so far?
In Canada, it appears this preventive medical treatment is being used to wipe out one native tribe. You should read that story. Canadian natives are not permitted to say “no” to any medical treatment ordered by the national health service. So they can either sicken and die from the medication or be arrested and/or driven off their land by the government. How nice.
Not gonna happen here? Can you say FEMA Camp for resisting the flu shot? But, they don’t just up and grab people here in the US! Ask Zeitoun. When the federal government gets involved, you are the enemy.
The more stuff like this keeps happening, the more I tend to believe wild reports the flu vaccine will actually be an injection of deadly virus itself.
Many people suffer from ringing, whistles, crackling in the ears. These sounds are continually called “tinnitus” by scientists. Their persistence because they are very disabling.
What’s more unpleasant, more annoying than hearing all day long (even at night) the noise in the ears? These invaders, they leave no breathing space, which leads inexorably insomnia, fatigue, depression, or depression.
Tinnitus is very diverse in their manifestations. They may involve one or both ears, giving you the impression that they invade your cranium.
They are from diverse backgrounds. They can be caused by illness or other circumstances “external” hard to identify.
The medical causes are, for example, infections, tumors, ear infections, circulatory problems, deafness, etc..
The causes “outside”, for example, age, Wax, dental problems, trauma, stress, prolonged or repeated exposure to decibel too high, etc..
This last question in particular, is that more and more young people suffer from tinnitus. The sonos nightclubs, mp3 players, stereos in cars are a major threat for young ears. The state seems to have been some concern by asking manufacturers to curb their devices. But there is still some way to go before everything is perfect. Youth education must be priority: too few are aware of the risks!
This diversity of possible causes that it is not always easy to diagnose and find the right cure.
Many tracks are exploited in recent years.
Traditional medicine can provide solutions in specific cases when the causes are medical. In treating the disease at the origin of tinnitus, they may disappear. Sometimes a simple hearing aid can also be mitigated significantly.
When the causes are not precisely defined, can be used, sometimes successfully, to natural medicine. The hardest part is finding the cure for everyone. There are so many different tinnitus that what may work for one person may not work for another.
The homeopathy, relaxation therapy, aromatherapy, relaxation, acupuncture, hypnosis, massage, yoga, mesotherapy, osteopathy – tracks are exploited and sometimes produce good results.
Finally, a healthy and balanced diet can help reduce problems caused by tinnitus. Healthier, your body will be better able to fight them. Avoid caffeine, tobacco, decrease your intake of salt, sugar, saturated fat; privileges certain vitamins such as vitamin A (eg carrots), B3 (eg oysters), D (fish, sun), E (soybean for example), trace elements (magnesium, manganese, iodine).
Of course, it is important that you consult a specialist before choosing a particular treatment.
Do not you despair. There is certainly a therapy that matches your type of tinnitus. It is for you to find it using all possible avenues to try to rid yourself of that haunting sound, haunting spoiling your life.
Plug and play: Two pulse oximeters, which measure blood oxygen levels, are linked with hardware that uses data from either device to control an intravenous drug device (not shown). Credit: CIMIT
In a key practical step toward the long-sought goal of linking different hospital devices together to better manage patients and their care, a Boston research group has come up with a software platform for sharing information among gadgets ranging from blood-pressure cuffs to heart-lung machines.
“The vision of fully interoperable medical devices has been around for at least a quarter-century, but lack of adequate standards and lack of manufacturers’ desire to foster such integration has left us in a kind of Dark Ages,” says Peter Szolovits, an MIT computer scientist in the Harvard/MIT Division of Health Sciences and Technology, who was not involved with developing the new standards. He adds that they are “a critical component of making health-care information technology smarter, safer, and more efficient.”
When doctors disconnect a heart-lung machine after finishing heart surgery, they need to turn on the ventilator quickly, or the patient will suffer brain damage. Right now, however, there is no way for the heart-lung machine to sense whether the ventilator was switched on correctly and keep running if it wasn’t. Even the most high-technology medical devices used in hospitals don’t “talk” to each other in the way that, say, your PC “talks” to your printer.
The new standards for the Integrated Clinical Environment (ICE)–written by a research group convened by the Center for Integration of Medicine and Innovative Technology (CIMIT), a hospital/academic consortium in Boston–consist of a set of high-level design principles. Among other things, the standard says that an ICE must include a device analogous to a jet airliner’s “black box” that collects data. This black box will initially prove that integrating different systems can be safe enough to win regulatory approval. But in everyday practice, it will also be crucial to troubleshooting and improving interoperability. The standard also says that there must be only one overarching algorithm that interprets data from all connected machines to avoid conflicting instructions or warnings; and that if one piece fails, the failure must not be able to spread to other parts of the system.
“This is about building a comprehensive platform, like the Web, that allows the global community to innovate and build cool things on top of it that improve patient safety,” says Julian Goldman, director of CIMIT’s Medical Device Interoperability Program, who led the group that developed the standards, which will be published this fall by the standards body ASTM International.
“Any technologically sophisticated person would assume that if you are receiving a potent intravenous medication in a hospital, and at the same time your blood pressure is being measured by an automated cuff every 15 minutes, that we have a way to [automatically] stop that medication infusion if it causes your blood pressure starts to fall or rise rapidly,” says Goldman, “but it’s impossible to do that today.”
Like many of you, I was saddened to read the news of Patrick Swayze’s untimely death – Roadhouse will forever be one of my most favorite movies. Unfortunately, there are those who will look to take advantage of any opportunity to push their pseudoscientific nonsense, just as the douchebags over at NaturalNews.com have done regarding Swayze’s death.
Swayze died of pancreatic cancer, and he fought the disease as best he could using science-based medicine. But in an article apparently based in an alternate reality, these anti-science-based medicine folks state that it is precisely because he relied on science-based medicine that he died. You’ve that right, folks: according to these deluded people, science killed Patrick Swayze! *facepalm*
Patrick Swayze dead at 57 after chemotherapy for pancreatic cancer
Beloved actor Patrick Swayze died yesterday evening after a 20-month battle with pancreatic cancer. Having put his faith in conventional chemotherapy, he largely dismissed ideas that nutrition, superfoods or “alternative medicine” might save him, instead betting his life on the chemotherapy approach which seeks to poison the body into a state of remission instead of nourishing it into a state of health.
Okay, so these morons start pushing the “chemotherapy = poison” line right off the bat. This is nothing more than a blatant attempt to scare people about a useful & serious method for combating cancer. By equating it with poison, they try to leave the reader with the impression that nothing good comes out of chemotherapy, despite the fact that it is one of the most reliable methods of treating cancer available. Which leads to the next part of the article…
Peter Jennings died following chemotherapy for lung cancer. Heath Ledger died following an accidental overdose of prescription medications (http://www.naturalnews.com/022602.html). Michael Jackson was killed by a doctor-administered injection of lethal painkillers. Famed newscaster Tim Russert most likely died from the fatal side effects of cholesterol medications (http://www.naturalnews.com/023434_T…). Former White House Press Secretary Tony Snow died after receiving chemotherapy for colon cancer (http://www.naturalnews.com/023626_c…), and Bernie Mac was most likely killed by pharmaceutical side effects (http://www.naturalnews.com/023817_B…).
In this screed of pure stupid, the NaturalNews.com goofs are displaying that time honored pseudoscientific trick of cherry picking: they are pointing out only high profile deaths associated with science-based medicine. The one, and monumentally important, fact they’re leaving out – intentionally, I think – is that there are vastly higher numbers of people who are treated & cured of their diseases & ailments using these methods than those who are killed.
And another thing to note is the slippery rhetoric used above… notice how in the cases of Peter Jennings & Tony Snow the article states that they “died after receiving chemotherapy”. They didn’t die because of the chemotherapy, they died from cancer – but the article gives the impression (again tying into the “chemotherapy = poison” nonsense) that it was the chemotherapy that killed Jennings & Snow! This is a common logical fallacy called post hoc ergo propter hoc, or “after this, therefore because (on account) of this” – implying that because these people died after they had chemotherapy that it must have been the chemo that killed them. It’s also a completely douchebaggy move to make, for reasons I’ll outline below after I vent my spleen some more.
And this next section of the article is perhaps the most reprehensible…
Western medicine offers no hope, no solutions
Of course, the cancer industry takes no responsibility for his death. Drug companies and cancer docs never accept responsibility for the way their poisonous treatments harm (and often kill) many fine people.
Had Patrick Swayze’s pancreatic cancer gone away, doctors would have hailed chemotherapy as the genius treatment that saved Swayze’s life. But chemotherapy has never healed anyone of cancer. Not once in the history of medicine. And when people die after being poisoned by chemotherapy, the oncologists and conventional medical doctors just shrug and say ridiculous things like, “The cancer was too far along” or “He didn’t fight it hard enough.”
No one fought cancer more diligently and optimistically than Patrick Swayze. Even after being diagnosed with an admittedly scary disease — pancreatic cancer — he remained upbeat and enthusiastic about beating the condition. He put more faith in conventional medicine and chemotherapy than perhaps anyone, and yet that medicine failed him just the same. No one can fault Swayze himself for a lack of optimism.
“I want to last until they find a cure, which means I’d better get a fire under it,” Swayze said in a highly-publicized interview with ABC’s Barbara Walters. No one apparently told Swayze the cancer industry isn’t looking for a cure. They’re looking for more business from more patients, and a genuine “cure” for cancer is flatly incompatible with the industry’s business interests.
I don’t even know where to begin with this steaming pile of crap. Essentially, this last bit is one big, long conspiracy-mongering rant against all forms of science-based medicine. They even say it in the section title “Western medicine offers no hope, no solutions”, by which when they say Western they mean scientific. This is, again, meant to reinforce the too-widely held belief that science-based medicine cannot be trusted because all it is is a vehicle for the pharmaceutical industry to make money, also known as the Big Pharma conspiracy. By painting any and all science-based medicine with such a brush, these “natural cures” woo-meisters hope to force people into believing a false dichotomy: that if science-based medicine is bad & useless, then by default the “natural cures” stuff must be good (despite the lack of evidence that such “natural cures” are useful at all)!
Folks, this is the same kind of argumentation employed by pseudoscientists of numerous stripes, from creationists to global warming deniers to all manner of medical quackery such as the “natural cures” crowd. Note that these folks do not offer any actual science-based evidence that their supposed cures will actually cure people’s cancer, they merely talk trash and attempt to make the medical & scientific communities out to be the bad guys. They are offering no solutions that can be scientifically tested & verified, they are merely feeding into people’s most base & nasty emotions in an attempt to pawn off upon them completely useless and un-regulated snake-oil “cures” which will do nothing but lighten your wallet while making you suspicious of actual medicine which works.
You know, now that I think about it, calling these people douchebags is kind of an insult… to douchebags.
Trento è una provincia autonoma all’interno di una regione ad ampia autonomia. Questo permette di fare leggi particolari che valgono sul suo territorio, il cui limite è disposto dalle leggi nazionali e dalla costituzione.
Il 6 Maggio la provincia ha fatto passare una legge, la n°4, di vari punti. Riguardava il trattamento delle medicine psicotrope ai minori. Queste medicine, che si potrebbero anche definire droghe per gli effetti a lunga durata che danno sui pazienti, sono in voga in questo periodo, specialmente negli Stati Uniti. Vengono prescritte per esempio ai bambini cosiddetti iperattivi, con defcit di attenzione e così via, e includono nomi famosi come il Prozac e lo Zoloft.
Una lista parziale di queste “droghe”, include anche dei farmaci ampiamente prescritti, tra cui tranquillanti, antidepressivi, stimolanti e sedativi.
La legge n°4 è stata bloccata perché incostituzionale. Essa prevedeva in sostanza che il “trattamento con sostanze psicotrope su bambini e adolescenti” fosse subordinato “al consenso scritto, libero, consapevole, attuale e manifesto dei genitori” oltre “all’obbligo del medico di informare il minore e di tenere conto della sua volontà assumendone l’assenso.”
Il comma 4 della suddetta legge prevedeva inoltre che “il consenso in forma scritta sia allegato a ciascuna prescrizione del farmaco contenente sostanze psicotrope.”
Secondo la Corte Costituzionale, la legge non è valida per vari motivi. Primo, la legge eccede gli interessi della provincia – in pratica non è competente a riguardo.
Secondo, “la disciplina in esame” viola la legislazione statale “che prevede il consenso informato solo per determinati trattamenti terapeutici, tra i quali non rientrano quelli relativi alla somministrazione di sostanze psicotrope.”
“In tal modo,” prosegue la sentenza, “risulterebbe violato anche il principio secondo il quale l’arte medica è libera e incomprimibile.” Perché le valutazioni devono essere fatte dal medico, mentre questa legge le sostituisce con la volontà dei genitori o “del tutore del paziente”. I quali sono “privi delle necessarie conoscenze.”
La Provincia di Trento ha obiettato su vari punti. Sostiene infatti che non sia un limite ai trattamenti sanitari, ma che sia un diritto della persona avere un “accesso più consapevole” alle pratiche terapeutiche. “Questa consapevolezza è tanto più necessaria nel caso di somministrazione di sostanze psicotrope su bambini e adolescenti.”
Particolare rilevanza assume il Piano sanitario nazionale 2006-2008, in cui si pone come obiettivo “la più ampia partecipazione del cittadino alle scelte terapeutiche ” e “considera il consenso informato come uno strumento già presente nel nostro ordinamento che deve essere ulteriormente valorizzato.”
Infine, “la Provincia osserva che l’Agenzia Italiana del Farmaco, con riferimento alla terapia della sindrome da iperattività e deficit di attenzione, già prevede il consenso informato.” Quindi la legge si limiterebbe a specificare come questo consenso consapevole si attualizzi.
Per concludere, la Corte Costituzionale ha agito bloccando la parte che prevede il consenso rilasciato in forma scritta. Forse è esulato dalle competenze della Provincia di Trento attuare una legge su questi temi, ma è opportuno che venga analizzata, a questo punto, a livello nazionale. Un consenso scritto dei genitori è vero che da una parte farebbe sorgere molti dubbi a questi se acconsentire o meno, ma favorirebbe un’analisi più accurata sulle medicine o metodi alternativi agli psicotropici. Inoltre, al momento dell’acquisto, sarebbe una garanzia in più della scelta consapevole verso i propri figli. La libertà della scelta medica ormai non è più limitata alla medicina “ufficiale”, ma si avvale di molti campi anche diversi tra loro. Dare a livello nazionale una scelta in più è un diritto. Costituzionale.
Health insurance exchange mechanisms are not without tradeoffs and by themselves are far from a perfect means to improve overall health insurance access. We identify five important legal obstacles to the optimal functioning of exchange programs, and we identify an additional nine economic issues that could potentially limit the value and effectiveness of health insurance exchange mechanisms. In terms of legal issues– even assuming states’ reforms involving risk pools, employer mandates, individual mandates, and exchanges will clear ERISA challenges– there are a number of other complicated legal issues that should be taken into consideration. These include portability and group versus non-group distinctions (i.e., Section 125, HIPAA, COBRA, and list billing) as well as the adverse selection and cost challenges posed by guaranteed issue and community rating. In addition to these complexities, there are a host of economic issues inherent to mandates and government-administered exchanges, chief among them are concerns over whether exchange mechanisms could improve access appreciably, the fairness of the programs, the costs of the programs, service quality, adaptation, and overall economic impact. Thus, given the dearth of studies of the legal and economic aspects of combinations of mandates and exchanges, it seems clear that more study should be done prior to the consideration of these policies.
Download PDF of Full Report Health Economics Consulting Group
At the core of the proposal to revamp the nation’s health care system is the creation of a government-regulated marketplace. On such an exchange, consumers would be able to shop for insurance, compare benefits and prices, and choose a plan that best suits their needs.
Most of the plans offered on the exchange would be issued by private insurers that meet strict government requirements, including minimum benefits packages, levels of allowed cost-sharing through co-payments and deductibles, and overall premium prices — to name just a few basics.
It was 1960. Jessica was nine years old and Rusty was ten. His family was Baptist and hers was Catholic. When his family moved into the neighborhood, Rusty became the youngest member of the thirteen boys in the neighborhood gang. One Saturday afternoon, the two girls of the neighborhood were walking home from the movie theater. Jessica said goodbye to her friend and headed home to help her mother.
Some of the neighborhood boys grabbed Jessica by the arms, held her, and threw a coarse rope around her neck. It happened so fast, she offered no resistance, and she pushed her hands between the rope and her neck to keep from choking.
The boys pulled her down the alley behind the houses. Jessica was tripping over her own feet, and fell several times, bruising her knees. She dared not cry for fear of what they would do to her. She couldn’t speak; she could barely breathe.
Finally they shoved her into her back yard. They pulled the rope taught until she turned red and tears streamed down her face. Mortified, embarrassed, hurt, and dying to run away, she wondered where her mother was. May be she was looking out a window and would come and rescue her any moment. Mom? Her mother never came. Jessica knew the utter feeling of helplessness at the hands of these young bullies.
Finally they all ran away. Jessica lay on the grass and looked up at passing clouds until she could quit sobbing and breathe again and her trembling would stop. She felt a hand touch her hand. She looked over and Rusty was sitting cross-legged beside her. He was crying too.
“I am so sorry. I didn’t want to do it. I couldn’t stop it. They are bigger than me, and so mean today. I want to be your friend, and I never want you to hurt again. I’m so sorry. I didn’t mean it……..” The rest of Rusty’s words were unintelligible through his tears.
Jessica squeezed his hand. She couldn’t say anything yet. And they understood each other. She forgave him, grateful for the offer of friendship.
September 11, 2001 had been a turning point for almost all people in the world. As regards me, I remember filling packing cases after a hard work’s day in the preparation of a significant move: to the Middle East; my departure scheduled only some ten days later. I was about to join a brand new faculty at Kuwait University when I switched on the TV and saw, again and again, Manhattan’s Twin Towers hit by airplane, and hit again, then collapsing. Only thirty minutes later I had received the first telephone call of a friend who tried to convince me that Kuwait would be safe and I certainly would not change my stance.
Well, I didn’t loose my courage although none of my new and most curious colleagues really expected me to come after 9/11. The new beginning was cumbersome but overall quite interesting. I met people from all over the world, a true international faculty. They had, though, very different profiles of courage. I learned to know rather anxious people who never really understood that Islam was a great cultural achievement and worth of being studied in detail. I met greedy people who were there for the money only. As usual in Academia, you always also meet people with highly problematic personalities, preventing any real collaboration.
The Kuwaitis were friendly and in essence very helpful. Some of my new colleagues from the West who had been there for some time complained, though, that they were snobby, considering themselves very special. Some allegedly even looked down to us, the western expats, coming for the money, the infidels.
As I settled, I became aware of a would-be colleague from the Ministry of Health who was somehow a relative of our Dean. Dr. I. presented himself as a VIP within Kuwait’s health system, a former MP, even a journalist; in fact a multitalented member of Kuwait’s closed society. He arduously tried to get into the faculty. When having been seconded, he quickly demanded giving lectures on topics he could hardly be considered to be an expert of. When finally appointed associate professor, he managed to serve in two independent departments.
The first Arabic word I learned in this context was wasta, or insider relationship, old boys’ network. Dr. I. represented wasta. Asking him a favor, one almost immediately got satisfied. He knew people and places. In his own private clinic he had employed numerous humble and subservient domestics. He could always count on their slavish obedience.
While his remote relative, the Dean, knew about Dr. I. but could not prevent him from joining the faculty, problems with him quickly emerged. Absurd criticism of expats led to early cessation of contracts. Then he attacked his Kuwaiti colleagues. There is a highly questionable rule at Kuwait University that a permanent appointment does not depend on scientific publications but rather on passing the American board examination or an equivalent qualification. Dr. I. had dozens of publications (which have to be considered worthless from a scientific point of view) and he was a specialist who had passed an equivalent board exam in Ireland. But some of his rivals among the Kuwaiti colleagues had not. If they were too close to his arch enemy, the Dean, he liked to question their qualifications. He usually involved the media and even the University President, who received dozens of letters of complaint.
On an especially revealing and even instructional occasion Dr. I. sent a pages-long email to the culprit, a very likeable young colleague with certain talents as a University teacher, where he referred to a certain hadith which is well-known among adherents of Shi’a Islam: mubahala. He updated this email, in which he accused his colleague of lying about the assumed expiration of his part II board exam, on a daily basis and sent copies of it to the President’s office, the Ministry and all faculty members. He even sent copies to students.
Mubahala reminds the pious believer of an incident in 631 CE (9 AH) when a group of Arabic Christians argued with the Prophet Muhammad which of the two parties erred in its doctrine concerning the nature of Jesus. Muhammad, after likening Jesus’ miraculous birth to Adam’s creation, called the Christians to mubahala, or cursing, where each party should ask God to destroy the lying party and their families. He then covered himself and his family (Ahl al-Bayt), i.e., his daughter Fatima, her husband Ali and their two boys Hasan and Husayn with a cloak. The Christian envoy declined taking part in mubahala and chose instead to pay tribute.
As far as I know, I was the only western expat who recognized the tremendous impact of Dr. I’s curse on our young Kuwaiti colleague. Muslims, who read through all the baseless accusations which were sent day after day to dozens of people, were deeply shocked. Mubahala is definitely exceeding the limits. Dr. I. did not fear any consequences for his ruthless defamation. But the young colleague eventually resigned and left the faculty for good.
Years later, I learned that Dr. I. is a pretty prominent liar himself. In 1990, Iraq’s dictator Saddam Hussein had invaded the tiny but oil-rich country in the corner of the Persian Gulf. A 15-year-old Kuwaiti nurse, who had only been introduced as Nayirah and who later turned out to be the Kuwaiti US ambassador’s daughter, testified to the Congressional Human Rights Caucus on October 10, 1990 that she herself had witnessed babies being taken out of incubators and being left on cold floors to die. The incubators were then taken to Baghdad. After the war, it became clear that another alleged witness, who had testified before the UN Security Council and the Congress that he had supervised the burial of 120 infants and personally buried 40 newborn babies who had died after taken from their incubators by Iraqi soldiers, had used false names and identities. This witness later revoked and admitted that he had never seen these atrocities. The alleged Dr. Issah Ibrahim was in fact our Dr. I., not a surgeon but rather a dentist. The notorious story is still remembered as the “incubator lie” which essentially served in motivating the World public to support America’s actions of throwing the Iraqi troops out of the Kuwait in Operation Desert Storm. More information can be found in L. May’s Crimes against Humanity: A Normative Account, Cambridge University Press 2004.
A notorious liar is suffering from a habit. A Kuwaiti lawyer who I once had asked for some support in a libel case, in which Dr. I. was involved, was very hesitant to accept the job. “Is it about libel?” he asked me. “But that’s the way how we do it in this society.”
I recently got to know that Dr. I. has lost a lawsuit in court against his faculty chairman and has now sued the University President.
Note: Profiles in Courage is the title of the 1955 Pulitzer-Prize-winning bestseller by John F. Kennedy, which describes the integrity and bravery of eight US senators. It profiles moral courage of highly reputed men in the history of the Unites States. Despite overall enthusiastic reception the later 35th US president was quickly blamed that he was the only man who won a Pulitzer Prize for a book which had been ghostwritten for him. The book has actually been written by his speechwriter Ted Sorensen.
My father was a good child. He always got good grades, loved his mother and respected authority. During WWII my grandmother told me that she married my grandfather and they were very much in love but then he became very abusive. He would lock my grandmother and my father in the cold attic with mice and cobwebs until he decided to come home. Then after he got home he would take off his belt and beat my grandmother until he was tired. Through Gods grace she was able to escape from his clutches and she did this mainly for my father. He was her shining star and she loved him very much. There was nothing that he wouldn’t do for her growing up, they were best friends. In his late teens he was drafted into the military and worked as a translator for the secret service. According to my mother who is from Thailand where they met, dad never saw “anything bad happen”, while he was over in Vietnam. He himself denies seeing anything negative happen during that time. But his mental state tells a totally different story. I remember him having fits of rage on a daily basis, calling my mother horrible names and then turning on us kids. I remember feeling scared when my parents would shout at each other and the fits of rage turned into things being thrown around the house (often past our heads). I have two younger brothers that are in their twenties and I am 35 and it has affected us all in very different and negative ways. I became suicidal and have been hospitalized on several different occasions and eventually was diagnosed with severe depression at the age of 20. My oldest brother has been diagnosed with bi-polar and some anti-psychotic disorder. My youngest brother is an alcoholic but the only responsible one in our whole family. After 32 years of abuse my mother couldn’t handle it anymore and finally had the strength to leave and divorce him. She came from a very poor family in Thailand and had almost no job experience. She now owns her own cleaning business and is doing alright for herself. War affects so many different people on many different levels. There is little or no help or support for military or x-military families and it’s just a shame. They risk their lives everyday for our country and come home mentally or physically wounded or in some cases both and do not get the help and respect that they deserve. I hope in the future that our country will not forget that mental illness is a very serious condition and help out military families.
Fred Coyote tells the story of an anthropologist who came to a Hopi elder to record some of his people’s songs. The old man took him out on the edge of the mesa and he sang a song. The anthro was recording and making notes and he said, “What is that song about?”
The old man said, “Well, that’s about when the kachinas came down into the mountains and then the thunderheads built up around the San Francisco peaks and then we sing and those clouds come out across the desert and it rains on the gardens and we have food for our children.”
And the old man sang him another song. And the anthro said, “What was that song about?”
The old man answered, “That song was about when my wife goes down to the sacred spring to get water to prepare food for us and to prepare the medicines because without that sacred spring we wouldn’t live very long.”
And so it went all afternoon. Every time the old man would sing a song, the anthro would say, “What’s that about?” And the old man would explain it. It’s about something or other – a river, rain, water.
Eventually this anthro was getting a little short-tempered. He said, “Is water all you people sing about down here?”
And the old man said, “Yes.” He explained, “For thousands of years in this country we’ve learned to live here. Because our need for this water is so great to our families and to our people, to our nations, most of our songs are about our greatest need. I listen to a lot of American music. Seems like most American music is about love.” He asked, “Is that why? Is that because you don’t have very much?”
——
This anecdote hit home when I first read it, and the more I learn about love, the more sense it makes. Our current cultural landscape values some things that are not necessarily breeding grounds for real love. It values youth above almost everything. (Craig Ferguson has a great rant about this.) Sexual gratification, often with as many partners as possible, is valued more than a partnership. Sometimes I think that having numerous sexual partners is part of having a real partnership, but I’m not convinced that that’s actually the case.
In any case, once you start understanding love and partnership you start seeing how wrong our artists often have it. For whatever reason it’s very difficult to explore true partnerships in art. As if a true partnership cannot be explained – it must be experienced. And then once it’s experienced, it’s not written about.
I have no idea why this is, but I would love to see it change.
My teacher has this type of true partnership, so he lives as an example for me, but when he dies, what happens to that example if it is not written down? He seems tickled by the idea of an “oral tradition”, that is, one that is not written down. One that must be experienced. There is no doubt that this way has its advantages, but I can’t help but think our culture could use some more outward, recorded expression of his type of relationship.
—
Links: Thea Elijah’s “Six Stages of Love Induced Disorder” – a beautiful study of the path to true partnership. Craig Ferguson’s rant on youth – really awesome summary of why, in his words, everything sucks .
In light of yet another breakthrough that harvests stem cells from a non-fetal source, and the fact that treatments from stem cells are STILL almost completely derived from adult stem cells rather than embryonic stem cells, do you feel at all silly or guilty over the past demonizing all of the opponents to ESC research received, especially during previous election cycles? And do you feel like the role you played was purely one of advocacy for abortions, in a pro-death, rather than pro-choice sense? Because it’s looking more and more like that’s what happened to me.
New research indicates there are advantages to using kava to treat anxiety, rather than pharmaceutical drugs or alcohol.
A University of Queensland trial of 60 people with chronic levels of anxiety has found anxiety dropped significantly in participants who took five kava tablets a day compared to those who took placebo pills.
Lead researcher, Jerome Sarris, says the trial shows that kava offers a natural alternative for the treatment of anxiety without some of the risks of conventional drugs
“It compares from what we can see looking at our data, quite favorably compared to the other two options because benzodiazepines have been associated with issues of cognitive side effects as well as the potential for dependency, and anti-depressants while effective can also illicit some side effects in people.”
Jerome Sarris says people do not lose their mental clarity when they take kava, as they do when they consume alcohol.
Vesna Jovanovic is an artist with scientific grace, Pareidolia, her new exhibit, depicts just that. Here’s her site where more of her work can be found and also posted is an overload of other anatomical creations.
A Student's Dream - from Dissection by John Harley Warner and James M. Edmondson
A Watercolor by Erich Lepier
From Scott Tension's Fragile Anatomy Exhibition
Deterioration by Proxy
All religions, arts and sciences are branches of the same tree. All these aspirations are directed toward ennobling man’s life, lifting it from the sphere of mere physical existence and leading the individual towards freedom. – Albert Einstein
On September 4th, 2009, Arizona Governor Jan Brewer signed HB 2013, a bill passed by the GOP-controlled Legislature that takes away health benefits from the unmarried families of hardworking state employees. The bill officially becomes law 90 days after the governor signed the bill, but it also includes language that establishes an effective date of October 1, 2009, the start of the benefits year for state employees. It is currently unclear exactly when state employees will lose their health care coverage for their unmarried, committed partner and their children.
Show your support and join the Facebook group, Give Me My Healthcare Back!
Surviving each day is like an adventure on its own. No. Wait. The adventure word gives it a fun-like connotation to it. It’s not. No way, sir. If anything, it’s the total opposite of fun. UN-fun. lol.
From dirtying my good pants with placenta blood… …to a maternal death from uterine rupture …to the most-distressed-of-fetal-distresses-that-I’ve-seen-until-I-couldn’t-believe-how-fast-the-staff-were-at-getting-the-patient-into-OT-that-stat, …to hyper-hormonal staff nurses where to a point it’s getting REAAAALLLYYY annoying at how I feel they’re ordering us around… …to…to.. can’t think of more at this late hour but I’m sure I will when I remember them…the list is definitely longer than this.
Of course not all is well and dandy in the labour room where expecting parents are overjoyed to receive their newborn babies. I’ve had the privileged of working in the high dependency ward inside the labour room and came across a case which has gripped my heart.
(I do realize that I usually blog about all the sad stories I come across… )
A young mother halfway though her pregnancy started experiencing symptoms suggestive of a deadly disease, which after many long days of investigations, the horrifying nightmare of the diagnosis was finally confirmed. The next difficult step was to decide what was the best solution for her and the baby given the terminal situation. It didn’t look good at all. It seems to appear that she might possibly have to give her life up for the sake of her baby. Really sad.
Sigh. Still counting down the days to when this posting will be over. In fact, everyday I keep wishing that time would pass by quicker.
36 days more (I think… not counting well in the middle of the night). lol.
Note: Thanks to Lauredhel for encouraging me to write this post; otherwise, it might have slipped through the cracks of “other priorities”.
——
For various reasons – mostly because I seem to have a lot of friends who are doctors – I’ve had the opportunity to chat to a number of doctors, nurses and midwives about birth. Particularly topical at the moment is the home birth debate (as I’ve been drafting this post, I see that the government has announced that it will no longer be effectively prohibiting home birth, although it still won’t be supporting it).
All of the doctors with whom I have had the home birth vs hospital birth discussion have expressed a clear preference for hospital birth. This is not because they think hospitals are perfect – most of the doctors I know work in the (public!) hospital system, and are aware of at least some of the failures of that system. Similarly, the nurses and mid-wives that I’ve spoken to who work within the hospital system generally expressed a preference for hospital birth.
The reason for this near-universal preference is, I think, for two main reasons: (1) they spend more time with the births that go wrong (especially the doctors), and those stick in their minds, and (2) they are incredibly risk-averse.*
And fair enough, I say. However, I disagree with their assessment of risk.
Lauredhel’s recent post, and the study she talks about therein, highlights some of the reasons why. In particular, this:
One of the interesting meta-things about this study is that hospital birth was considered the norm for the relative risk analyses, the “1.00″ to which home birth was compared. Flipping the numbers and considering home birth to be the norm would mean that we would have to talk about the relative increase in risk for neonatal and maternal injuries, and that in many cases the risks would be more than double.
The people I’ve spoken to who work within the hospital industry (whether doctors, nurses or midwives), as well as various others (in particular, older white men who are, or may soon be, grandfathers), seem to follow a risk analysis that goes something like this:
1. Mothers and babies sometimes die in childbirth.
2. This can happen even when everything appears to be normal.
3. In fact, [anecdotal story about a woman for whom everything appeared to be normal, but whose baby needed to be resuscitated after birth - lucky she gave birth in a hospital or that baby would have died!].
4. Therefore everyone should give birth in hospitals, because otherwise death might occur.
You might notice that none of the other risks (the “lesser” risks) come into this argument. All the people who use that risk analysis are worried about is possible death.
And you know what? It’s difficult to argue with that; it’s difficult to say: “ok, on the one hand, my child might die but at least I won’t be unnecessarily hurt in the process – on the other hand, the doctors will do what they think is necessary to save my baby and I might get hurt, but at least my baby won’t die”.
It is especially difficult to make that argument when the person making the above argument is YOUR doctor, and zie is reminding you that zie needs to take into account your baby’s benefit as well as yours, particularly given our cultural respect for doctors and the authority they are generally accorded.
(It goes without saying that the enormous majority of mothers – as in, 99.99999% or so, I’d imagine – want the best outcome for their child. I’d also guess that the typical mother also does not want to be perceived as some crazy hippy who is ignoring SCIENCE and putting her baby’s life at risk.)
This is why research projects such as the one that Lauredhel outlined are so important. As she points out, the paper not only shows that home birth is safer, but there is a suggestion – although no conclusion – that being in hospital actively increases the risk, not only of injury, but of some event requiring resuscitation.
Why is that so important? It allows someone to argue against the anecdote at step 3 of the doctor’s argument I’ve outlined above. It’s intellectually dishonest – and unscientific! – for a doctor to use that argument. (An independent midwife I know referred to doctors being manipulative, and I believe that it’s that sort of behaviour – using anecdotes as if they are data, and doing so with a doctor-ish “I’m medically-trained” kind of authority – that she was talking about.) But I do understand that they’re doing it in good faith – they don’t want their patient (indeed, patients) to face the risk of death.**
What they need to be told, loudly and clearly, is that there’s a good chance that the risk of death that they’ve observed may exist only because the woman was in the hospital in the first place, not because of some innate risk in the pregnancy that wasn’t apparent until the baby emerged. So not only is their anecdote intellectually dishonest and unscientific, but, by using it, they are, potentially, actively putting their patient(s) at risk of the very event they are trying to prevent, in addition to the other risks outlined in the study (such as risk of injury).
Of course, the study makes no findings about correlation, so it is not possible to say, definitively, that going to hospital actually causes those higher risks. I’m not trying to say that it does. My point is that it is at least as valid a conclusion to draw as the “anecdata” approach I’ve heard several doctors use.
I noted above that I’ve heard several men (particularly of the older, white, grandfather-age variety) use a similar what-if argument. The context of at least two of those arguments was “women shouldn’t be allowed to give birth at home”. My take is that even if the risks of home birth were slightly higher than for hospital birth, that alone is not necessarily a reason to outlaw it (my opinion on that might have depended on precisely what the risks were, how likely, how possible it was to diagnose before pregnancy, etc), and that the important thing was that women should have the choice. One of them was turning the argument quite personal, and I assured him that nobody would force him to give birth at home.
Anyway, this attitude is reflected in the very first comment at this article, which Lauredhel pointed me to, although the comment is by a father, rather than a grandfather (there are similar comments later, one in fact by “Grandfather of 2″). It may also be worth noting that the older, white women who were grandmothers or potential grandmothers were much more open to the idea of home birth being safe (although they may not have been totally convinced that it was “as safe” as hospital birth).
This makes me wonder if the concept of control, or, rather, perception of control has anything to do with the attitudes of men. But that’s a digression that I’m simply not getting into here.
Ultimately, though, studies like this really show that where you stand on the home birth/hospital birth debate (assuming no diagnosed complications) really comes down to whether you think that any risk of death outweighs the risk of other injuries, which have a much higher probability of occurring, especially if you give birth in a hospital.
Given that we take hundreds of risks each day in which “you/your baby might DIE!” (travelled in a car recently?), I do think that we need to keep that in perspective. Where death is an incredibly low risk in any case, it is important to also consider other risks, which may be objectively “lesser” risks, but which undoubtedly have a much higher incidence.
(By the way, I find the “women have been giving birth for centuries without medical intervention so of course home birth is safe!” to be just as intellectually dishonest as “but you might DIE!” Better hygiene, medical technology and much better general health have made birth a lot safer. It seems to me that the medical technology contribution is largely because we can now diagnose so many potential complications (and then deal with them if/when they occur). That very fact (and the better hygiene and general health) is what allows home birth to be so safe. A woman who chooses a home birth has usually made use of medical technology to make that choice. The midwife attending the birth will most likely bring medical technology with her. It’s not that she’s rejecting medical technology; it’s not that she’s simply doing things the way our foremothers did them. She’s actively using medical technology in an entirely appropriate way to inform her decision.)
* By the way, I’m talking about individual doctors here, who I think usually do act in good faith. Not so sure about the AMA. My reading of the AMA’s submissions to the Maternity Services Review suggests that organisation has acted somewhat disingenuously. I say that because they base their submissions on a study that is 10 years old, which used data that were 10 years old and over at the time (ie the data are now 20 years old and over), and even then, the AMA misrepresented the findings in the study in order to bolster its own interests. Way to go, AMA, if you want people to trust you. I saw that the Good Weekend article on home birth – which was pretty good – picked up this little piece of dishonesty on the part of the AMA, too.
** My doctor friends tell me that my profession has something to answer for here, too.
ETA: Of course, I posted and THEN I saw Helen’s excellent and related post, looking at the perspective of risk in a different way. Which possibly ties in with my comment about control, the one I didn’t elaborate on.
Lacey is on 250 mg of Metronidazole and needs to take a half tablet once a day for 6 days.We tried giving it to her orally but she wouldn’t take it.She’d sniff and turn away.We tried taking a piece of chicken and cutting it and stuffing her medicine in the chicken but she ate the chicken and spit out the pill.So we had two more chances.That was to grind up her medicine and put it in chicken noodle soup from the can not heated and see if she’d drink her soup.She did drink a few sips but after a couple licks she didn’t want anymore so we went to the last resort which was take the chicken noodle soup base mixed with her grinded pill and put it in a syringe to squirt it into her mouth.Well,she didn’t like it one bit.After she was trying to get the taste of the medicine out of her mouth.So far she’s got no side effects from it.Her appetite is good.We’ll see and I will be watching out for the side effects if any.Otherwise we will be sure to call Dr Kaya.Don’t want anything to hurt her body.
I’ve been working this month in the intensive care unit (ICU). The name says it all – it really is an intense place to be, at times. I’ve been fortunate to be working with a more senior resident, who knows how to run the show, as I bumble along for the first time in such a rotation. I’m learning a lot about respiratory distress, figuring out the nuances of putting people on (and taking them off) ventilators, treating people with about 6 different diagnoses that interplay, and watching complications from aggressive therapy as they emerge.
Being useful here isn’t as easy as you’d think. I do my best to write a thorough note about the patient and our plan for them, but sometimes it is well over me head. A mentor-figure had advised us new residents to do the following to be happy and healthy as doctors:
Each day, strive to learn one thing, and to help one person.
Yesterday, I learned about patients who are given lots of Lasix (furosemide) – a drug we use very frequently in patients whose hearts aren’t pumping well (congestive heart failure, often secondary to a heart attack or valve problem) to clear out the fluid which has backed-up into their lungs. Oft-described by patients as a ‘water-pill,’ we will use an intravenous version of the drug. It makes you pee like a race horse, but it can provide great subjective relief in those struggling to breathe as result of the fluid on their lungs, or what we call in fancy terms, pulmonary edema.
Lots of patients come to us in the ICU after having heart attacks, and when the blood supply is cut off to the muscle of their heart, the heart as a pump starts to fail. Fluid backs up into the lungs, and they have a hard time breathing as a result. There are plenty of downsides to the drug, but one that I was unaware of, is that along with the water, it also makes us pee out thiamine – vitamin B1 - (A) as well as inhibiting absorption of it (B) . Being deplete of thiamine is bad news. It can cause further heart problems, via a state called beriberi, or, as we sometimes see in alcoholics, a very very (potentially) terrible neurological condition known as Wernicke-Korsakoff’s Syndrome. So, my preceptor suggested giving everyone in heart failure, who is bound to get this drug, a regular supply of thiamine.
In addition to learning this, I helped someone. We have a patient with a severe infection who is suffering also from delirium, presumably as a result of the infection. He is confused, disoriented, and in some distress when we try to talk to or examine him. I pulled out my ‘naive family practice resident’ card and I wondered if the fact that his chronic pain condition was being untreated at the moment could be a contributing factor. This person was previously on copious amounts of narcotics, but they were not ordered (purposely) in hospital so as to not cloud the clinical picture. However, their pain and potential withdrawal from the medications might have been a factor in why they were still very confused despite having had aggressive treatment for the infection. We re-ordered the pain medications and we’ll see how it goes from here. I was proud that, although my mind is not a ’steel trap’ like those of the internists and intensivists, I could still contribute something worthwhile.
So, yesterday was a happy and healthy day for me.
—
A. Zenuk C, Healey, J, Donnelly J, et al. Thiamine deficiency in congestive heart failure patients receiving long term furosemide therapy. Can J Clin Pharmacol 2003;10:184-188.
B. Zangen A, Botzer D, Zanger R, Shainberg A. Furosemide and digoxin inhibit thiamine uptake in cardiac cells. Eur J Pharmacol. 1998;361(1):151-155.
I saw this on Fox News last night. I love this woman! (h/t to HotAirPundit)
Catherine Bragg spoke out at a recent town hall meeting on health insurance reform with Rep. Lynn Woolsey (D) 6th congressional district of California. She said what I have been saying for more than a month: If you’re worried about the cost of health insurance let insurers compete. Stop restricting the health insurance market on a state by state basis. Bring in tort reform to stop frivolous medical lawsuits.
I would add: Let health care institutions expand as market demand increases. Do not allow government to quash small health care providers in favor of big ones.
I’ve heard someone else suggest this and I think it’s a good tactic. When proponents of government-run health care complain about the “free market” in health care just ask, “What free market?” There’s limited competition in health care. The competitive aspect is regulated by various government institutions and this can only drive up costs. I want government to regulate the quality of care. I do not want government to control access to care directly by limiting when and where health care providers can expand to meet demand, by severely limiting the coverage options in health insurance, nor indirectly by limiting which insurers can operate in which states. Freedom and open competition are the best salves for this problem.
The Soros Connection – The Czars And Their Place In The White House
Part 2 – The Soros Connection,Glenn’s Interview With A Reformed Communist
Glenn Beck – Interview With George Horowitz – The Communist Connection
Assault On Free Radio – Glenn Beck- FCC And Your Ears – Localism
Assault On Free Radio – Glenn Beck and Rush Limbaugh – FCC And Your Ears – Local-ism
GLENN BECK IS TODAYS PAUL REVERE – COMMUNISTS IN THE WHITE HOUSE
Did President Obama, Secretary of State Clinton, or Attorney General Holder Vigorously Protest The Release of The Lockerbie Convicted Murderer To The United Kingdom’s Prime Minister Brown, Foreign Secretary Miliband, or Lord Chancellor Straw? If Not Why Not?
Background Articles and Videos
Obama’s Czars
Afghanistan-Pakistan (Af-Pak) czar, Richard Holbrooke
AIDS czar, Jeffrey Crowley [openly gay white man]
Auto recovery czar, Ed Montgomery
Behavioral science czar, position not yet filled
Bailout czar, Herbert Allison Jr., [replaced Bush bailout czar Neel Kashkari, Assistant Secretary of the Treasury for Financial Stability confirmed by Senate]
Border czar, Alan Bersin
Car czar, Ron Bloom [Counselor to the Secretary of the Treasury , under Senate oversight]
Climate change czar, Todd Stern
Copyright czar, not appointed yet
Counterterrorism czar, John Brennan
Cybersecurity czar, position will be vacant on August 21st [upon the departure of Melissa Hathaway]
Disinformation czar, Linda Douglass [This is a new media buzz since our earlier list, a response by pundits to the White House request for informants: see Glenn Beck and Lew Rockwell]
Domestic violence czar, Lynn Rosenthal
Drug czar, Gil Kerlikowske
Economic czar, Larry Summers
Economic czar number two, Paul Volcker
Education czar, Arne Duncan
Energy czar, Carol Browner
Food czar, Michael Taylor [a former Monsanto executive, or, the fox in charge of the henhouse]
Government performance czar, Jeffrey Zients
Great Lakes czar, Cameron Davis
Green jobs czar, Van Jones [who has a communist background]
Guantanamo closure czar, Daniel Fried
Health czar, Nancy-Ann DeParle
Infotech czar, Vivek Kundra [Shoplifted four shirts, worth $33.50 each, from J.C. Penney in 1996 (source). His last day in DC government was March 4 but on March 12 the FBI raided his office and arrested two staffers.]
Intelligence czar, Dennis Blair [Director of National Intelligence, a Senate confirmed position. He is a retired United States Navy four-star admiral]
Latin-American czar, Arturo Valenzuela (nominee) [although this post is referred to as a czar, he is nominatied to be Assistant Secretary of State for Western Hemisphere Affairs and so is subject to Senate confirmation. Voting on his confirmation was delayed to clarify his position on Honduras. Watch WaPo’s Head Count to track status of confirmation.]
Mideast peace czar, George Mitchell
Mideast policy czar, Dennis Ross
Pay czar, Kenneth Feinberg
Regulatory czar, Cass Sunstein
Religion czar, aka God czar Joshua DuBois
Safe schools czar, Kevin Jennings [appointed to be Assistant Deputy Secretary of the Office of Safe and Drug-Free Schools, a newly created post (that does not require Senate confirmation); openly gay founder of an organization dedicated to promoting pro-homosexual clubs and curricula in public schools]
Science czar, John Holdren
Stimulus oversight czar, Earl Devaney
Sudan czar, J. Scott Gration
TARP czar, Elizabeth Warren [chair of the [Congressional Oversight Panel for the Trouble Assets Relief Program; note that Herb Allison is frequently called the TARP czar]
Technology czar, Aneesh Chopra
Trade czar, Ron Kirk
Urban affairs czar, Adolfo Carrion
War czar, Douglas Lute [retained from Bush administration, married to Jane Holl Lute, currently a Deputy Secretary of Homeland Security]
Water czar, David J. Hayes [a Deputy Interior Secretary and therefore subject to Senate oversight]
Weapons czar, Ashton Carter [actually Under Secretary of Defense for Acquisition, Technology, and Logistics and so subject to Senate confirmation]
Student loan czar, to oversee a program of mandatory service in return for college money (source)
Voter list czar
Zoning czar
http://frontpage.americandaughter.com/?p=2385
David Horowitz – Party of Defeat
Glen Beck Interviews David Horowitz
David Horowitz – UC Santa Barbara
Marxist professors try to radicalize students. David Horowitz expose them in, One-Party Classroom
Riz Khan- David Horowitz- 21 Aug 08- Part 1
Riz Khan- David Horowitz- 21 Aug 08- Part 2
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Gore Grilled & Gingrich Gouged–American People Oppose Massive Carbon Cap and Trade Tax Increase–Videos
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Al Gore: Agent of Influence or Useful Idiot of Disinformation
Al Gore: Agent of Influence and Planetary Propeller Head!
Al Gore’s Little White Lie: Man-Made Global Warming Causing Polar Bears To Drown
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1984-Videos
A Brave New World–Videos
Battle of Waterloo–Videos
Before The Fall or Napola–Videos
Gattaca–Videos
Hitler: The Rise of Evil–Videos
The Hitler Gang–Videos
The Wave–Videos
