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Politics

Strange Timing

I’ve had a few more thoughts about the recommendations of the USPSTF recommendations since my last post. Suspicious thoughts. One’s I thought I’d share.

One of the centerpieces of the current health care reform debate is the idea that there’s a need to be more efficient and effective in our use of health care resources. That there is a need to assess what works and what doesn’t in order to minimize costs. And to have a more universal approach to treatments. (What we have now varies widely depending on where you live). Sounds like practical advice for the most part. But out of this idea came the idiotic notion that there would be “death panels” deciding who gets care and who doesn’t at the end of life. This idea has thankfully largely been debunked.

Now we have a panel that seems to have done this effectiveness analysis on another level. They looked at the data regarding routine mammograms as a tool for detecting breast cancer (not as a diagnostic tool) vs the risk from radiation. Apparently they believe that statistically it’s a wash and therefor not worth the risk.

Considering only raw numbers and statistics I can possibly see how they’ve come to this conclusion. What strikes me is there’s an interesting and rather obvious parallel here. Looking at health this way is exactly what insurance companies do. Raw numbers, bottom line, statistics – that’s how they make their decisions.

So we have here a government panel looking a lot like an insurance company. And we have a great deal of outrage generated by the advice of this panel. I then begin to question motives in the timing of the release of these recommendations – coming right when the health care reform debate is peaking. Is this a ploy to manufacture outrage against health care reform? Is it to provide ammunition for those who want to say “see, you don’t want big bad government interfering with medicine”? I don’t know about you but it seems awfully strange timing to me.


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Gendercide?

Through the busyness of my day today I caught wind of the latest report by a group of doctors called the US Preventative Services Task Force (USPSTF). I’m all for improving health care by encouraging better preventive care. Good, well rounded preventative care will keep us all healthier. But the decisions of this group are indeed quite puzzling. Beyond puzzling. They’ve gotten me so incensed that I’m firing off this hastily written post. In case you haven’t heard yet this panel has reversed an earlier recommendation, by the same group (but with different members), and now don’t think women between the ages of 40-49 should routinely get mammograms to screen for breast cancer. The key word here is “routinely”. The don’t flat out say no one in this age group should get them, just that the risk vs benefits should be a conversation between the woman and her doctor and a decision made from that point. Shouldn’t ALL of us be having thoughtful conversations with out medical providers about a whole host of risk vs benefit situations? Isn’t that a sound place to begin taking better care of ourselves? That conversation isn’t the problem. What I see as a huge potential problem is now women and their doctors may face additional battles when it comes to paying for these mammograms. And coming at a time when the country is hashing out the details of health care reform makes me all that more suspicious of the motivation behind these recommendations. If you can’t see the potential problems with insurance companies and these recommendations then you’re rather blind to how insurance companies are working these days. Oh, they might not make changes right away – they’ll wait until the news of these recommendations has left the media news cycle before they do that.

Aside from the issue of mammograms I find another recommendation of the panel even more startling and disturbing. Unbelievably they don’t think doctors should be teaching their patients about regular self breast exams. Apparently they’re worried about the poor widdle women having anxiety if they find something. Excuse me?!?! Anxiety? You’ve got to be kidding me! How about educating women that breast cancer is quite survivable especially when detected early. Or teaching them that just because you’ve discovered a lump it doesn’t even mean you have cancer for goodness sakes. That would go a very long way to reducing anxiety. And I’d sure as hell rather be anxious than dead. Hell, why not teach patients how to deal with anxiety. And I’m not talking about prescribing another little “fix me” pill. I’m talking about proven stress reduction techniques. How about treating women as the intelligent adults we are?

This recommendation is so outrageous I’d almost go as far as to think that this borders on gendercide. I know, that’s taking it a bit too far considering the statistics but come on, why in the world should doctors be encouraged to have their female patients know LESS about their bodies? Unless perhaps if you know less about your body you’re less apt to ask intelligent questions of your doctor and more inclined to buy something from big daddy pharma to fix your problems.

Guess what? I don’t give a frak what this panel says about breast exams I intend to continue to be well acquainted with the look and feel of my breasts. Hell I may even continue to enlist the help of others in keeping track of any changes. I encourage every woman reading this to do the same and every man to encourage every woman they know to do the same too – and to teach your children about the importance of being well acquainted with their own bodies. And you, my not so esteemed panel of “experts”, ought to be downright ashamed of discouraging self knowledge. How the hell is that “preventative” medicine? How do you explain violating your oath of “do no harm”?

The next thing I’m curious about is what they’ll have to say about testicular cancer.


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Why this time it’s different

I’ve watched a fair number of inaugurations in my life so far. Sometimes I’ve been excited, sometimes watched with dread. But I don’t know if I’ve ever been so deeply moved as today.

It’s not because he’s black, although I recognize and honor that fact.
It’s not because he’s not Bush, although the relief I and many others feel about that fact is immense.

It’s because he begins with gratitude and because he places the responsibility squarely on the shoulders of each and every one of us. No one person can make the changes these times require. But one can lead the way. And one can reminds us all once again how to hope.

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Change is in the air

Sitting here starting to watch the events leading up to the inauguration of Barack Obama I find myself overwhelmed by what I’m witnessing. Words are hard to find to describe this. Just now a thought sums it all up…

On the morning of September 11, 2001 the world changed in an instant.

On the morning of January 20, 2009 it will change again.

Fill your lungs with the fresh air of this change and make it your own. It belongs to all of us  -  as does the work ahead.

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A Confluence of…

Ingredients:

Coal ash spill in Kingston Tennessee on December 22
Coal ash spill in Stevenson Alabama on January 10
A new series of television ads against “clean coal” technology first aired the week of December 5
Lack of reporting on the causes of the coal ash spills

stir together thoroughly and ponder the proximity of locations and events

There is something about this that doesn’t sit well with me. Could it be that rabid environmental activists are involved in creating these spills? I don’t know. I don’t much like coal fired power plants but I also know implementing alternatives will take time. And we now have severe environmental damage due to these spills that will likely take generations to clean up. Activists have been known to take similar drastic actions in the past. Think arsons in Colorado, bombing of research labs etc.

Another example that’s got me thinking “what’s wrong with this picture”

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How Long

1775-1781 – Revolutionary War 7 years

1781-1787 – Articles of the Confederacy 6 years

1787-1789 – Constitutional Convention 2 years

1775-1789 – Fourteen Years

 

How long should it take to build a democracy? Lots of folks are clamoring that four years in Iraq is too long, too many of our young people have died, it’s time to get out now! Any deaths in a violent conflict, for make no mistake this is not a war (congress hasn’t had the balls to declare war since WWII) are lamentable. Especially when that violent conflict was a mistake to begin with. But once you have take it upon yourselves as a country to violently overthrow the government of another country how long does your responsibility for that country, and the innocent people who live there, last? What if say the state legislature of New York were disbanded and the governor hung for crimes? How much lawlessness and chaos would ensue? Add to that a heavily damaged energy infrastructure and transmission system in shambles along with a barely functional transportation system. With out these basics the economy would be a wreck as well. Could we put the pieces back together in just four years? How long will it take us to rebuild New Orleans? and here we all basically speak the same language. We don’t have brigades of Chinese soldiers “helping” us to rebuild via translators or contractors from Russia with private guards “fixing” things. Rebuilding a single city, let alone an entire country, will take a long long time.

 

And what again about democracy? What is the magic number at the end of the formula for how long it should take? How many citizens of the USA are aware that there were fourteen years between the beginning of the Revolutionary War at Lexington and Concord and the swearing in of George Washington as our first President.(I’m betting that most of those that do have recently been sworn in as immigrant citizens at that) Fourteen years! And that was with a culture that had decades if not centuries of experience with various forms of representative governance and democratic ideas.

 

The clamoring to pull out of Iraq now and the posturing by various politicians is an embarrassment to the honor of this nation. Well, what little honor we have left. Once we took on the responsibility of destroying the government of Iraq we also took the responsibility of the long hard slog of rebuilding a government. Being stuck there now is the prime reason we shouldn’t have invaded. We shouldn’t have done it in the first place but now that we are there if were are to retain any semblance of decency we must stay until there is some stability, no matter how long it takes or how many soldier’s lives are lost. It’s the least we can do.

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Making sense of voter registration

does this make sense to you…

I just renewed my California driver’s licence via the US mail. Great, glad that was easy since I’ve got travel coming up in my renewal month of October. However, enclosed was a form for voter registration. All that was required was to fill it out and sign it stating that everything on it was true (and that you’re over 18 and a citizen). Uh, isn’t that an awfully easy way to offer fraudulent voter registration? I mean really, do you think that someone who wants to fraudulently register will care that they’re lying on a mail-in form? All that’s asked for, besides name, address, date and place of birth is either your driver’s license number or the last four numbers of your social security number. Give me a break. You don’t have to be a citizen to have a driver’s license and it’s ridiculously easy to make up four numbers of a SS # or get a fake one. Is it any wonder that politics in this country is a joke when we pay so little attention to the most basic of privileges of a democracy.

postscript…

from the back of the form

“If you do not wish to register to vote, your decision will remain confidential and will be used only for voter registration purposes”

huh?

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