keep your finger away, doc

Hey, whaddaya know? Those PSA blood tests for prostate cancer "saves few lives and leads to risky and unnecessary treatments for large numbers of men". Large numbers? Apparently, a positive biopsy leads to risky and painful treatment when the fact is, only 1 out of 50 guys with that diagnosis actually ever get prostate cancer.

But gosh, they are just so profitable, let's keep on doing them, right? What else does a specialist have to do?

everybody's in favor of health care reform...

At least so it would appear from the health care summit President Obama held at the White House. Insurers, politicians, big business - all making positive noises that reform is needed, the current system fails many American patients and businesses, etc.

But I thought Utah Senator Robert Bennett (a Republican) sounded an appropriate warning. He agreed with "absolutely everything" Bill Clinton said in his 1993 address to Congress... but then disagreed with almost the entire plan.

From the Post: "Bipartisanship is not just a nice thing we say to each other before we touch gloves, go to our corners and come out swinging when the bell rings," Bennett said. Health reform will require "wrenching change," he added. If it is to succeed, political leaders in both parties will have to "join hands and jump off the cliff together."

I happen to think this can probably be done without 100% Republican support. But some would be good...

let's be more like canada, eh?

We like to make fun of our Canadian neighbors. But you know, they have some good things going for them.

Like health care. Nick Kristof has a good column picking apart the kneejerk reaction to the idea of national health care that "we'll all have to wait months for an operation like in Canada."

Well, a health care system that gives us, at the price of the highest expenditure on health care per capita in the world ($6800), a lower life expectancy than Cyprus and children that die twice as often as in Portugal and women that die in childbirth three times more often than in Greece maybe isn't the grand bargain you think. Especially when you remember that when you lose your job, you lose your insurance too - a double hit.

Maybe the Canadian system isn't so bad.

And now as we pump cash into AIG and Citibank and count the dead and dying banks, we can look north and see a country full of healthy banks. In fact, Canada has the healthiest banking system in the world. Why? A combination of cautious regulation and cautious moves by the banks themselves.

So personally I'd love to be a little bit more like Canada. Although I will draw the line at hockey.

revolution?

It's a bit dizzying. President Obama and his administration are going to propose big changes in health care funding explicitly aimed at "getting health-care reform done this year" as White House domestic adviser Melody Barnes said.

I really want this to work. But I still can't be sure it will. GOP leader John Boehner says "Everyone agrees that all Americans deserve access to affordable health care" then immediately starts carping about taxes on small businesses. Hey, a lot of small businesses will be relieved to be out from under the stress of having to support health insurance for their employees, a situation where sometimes a catastrophic illness for an employee can become an insupportable burden on the business as well.

And lo and behold, the budget includes revenue from a cap and trade scheme on carbon emissions in 2012. To finish that this year, as well as health care and doing whatever it takes on the banks and economies, would be a challenge. Republican Senator John Barrasso (who's he? Wyoming) called the climate thing "a trillion-dollar climate bailout."

Dude, if we could bail out our climate for only a trillion dollars, it would be the single best investment in humanity's history.

I think David Broder is actually right for once - it is a bit of a gamble. But I don't think Obama has much choice. The tanking economy makes the current health care "system" even WORSE for Americans as many of us are laid off and therefore at exposed risk of bankruptcy and worse from medical conditions no longer covered. And we may be too late on the climate anyway - Congress needs to do something realistic, especially before the year-end UN climate change conference in Denmark.

time to move on health care

Paul Krugman puts it well - this is exactly the right time to move on providing health care now.

Unemployment is an economic AND a health crisis. It will NEVER be cheap. Doing it now will give something to the "regular" American, while we're bailing out bankers.

Don't wait, President Obama.

the whole insurance thing is breaking down

An interesting article - the first of three - from the Los Angeles Times about how the American employer-based health insurance system is eroding.  From the article:

On Wall Street, they showcase their efforts to hold down expenses and maximize shareholder returns by excluding customers likely to need expensive care, including those with chronic diseases such as asthma and diabetes. The companies lobby governments to take over responsibility for their sickest customers so they can reserve the healthiest (and most profitable) for themselves.

And we all know how hard it is to get private health care insurance if you can't get it thru your employer.  John McCain's $5000 tax credit won't help much - if you have a pre-existing condition that won't make even a dent in annual premiums, if you can even find somebody willing to insure you.  The big insurance companies primary activity is finding reasons to deny insurance to those who need it, and trying not to pay for procedures and medicines for those they deign to insure.

The system, always a jury-rigged thing that is an artifact of World War II wage caps, isn't working - if you define "working" as providing Americans with reasonable access to health care.  It works just fine for the big insurance companies' bottom lines.

another reason for a national health insurance system

From today's Washington Post: Health and life insurance companies have access to a powerful new tool for evaluating whether to cover individual consumers: a health "credit report" drawn from databases containing prescription drug records on more than 200 million Americans.

In other words, if you have a history of taking medication commonly associated with high cholesterol you will have a hard time buying health insurance. If you have a history of taking medication commonly associated with depression, you will hae a hard time buying life insurance.

Compiling such "health reports" is economically rational from the perspective of insurance companies. Their goal is to ensure that payments for medical services are less than what they take in in the form of premiums.

But it is more and more apparent that this system is not rational from a national economic or health perspective. Overall, we as a nation (let alone as individuals) benefit from keeping somebody's cholesterol levels under control. Taking a step further, we benefit even MORE from keeping people from having high cholesterol levels in the first place, but the medical sector hasn't figured out a way to make a profit on prevention - but prevention is clearly the most economically beneficial outcome for the country as a whole, and for individuals.

"pro-life" drugstore comes to suburban washington

A Jesusier-than-thou pharmacist name of Robert Semler is opening a so-called "pro-life" pharmacy in Chantilly, Virginia. That is in the sprawling suburbs of Washington DC.

A "pro-life" pharmacy means, no condoms, no birth control pills, no morning-after pills, none of that. (But you can still get your wood-in-a-bottle I mean Viagra. After all, Viagra PROMOTES pregnancies.)

Apparently, there are only a few of these preachy drugstores around the country. So far. But they are raising concerns. One is that if these places become prevalent in rural areas with few nearby alternatives (the Chantilly pharmacy is in the same shopping mall as a K-mart with its own pharmacy), women will find it harder to buy legal birth control products. Which of course will increase demand for abortion but the god-boy pharmacists don't let that logic get in the way of their professional preaching.

My bigger concern is, if such "pro-life" pharmacies become more widely acceptable, will people then begin to protest at regular drugstores, forcing them to remove condoms and contraceptives, and make those things harder to get for all of us? Will pharmacies become the new abortion clinics, with angry holier-than-thou preachy busybodies outside picketing and calling anybody who gives that store their business - even just to get some potato chips or cold medicine or something to remove a wart - complicit in "murder" for shopping at a "pro-abortion" store?

You know, the usual calm, reasoned pro-life tactic.

bird flu returns to the news

For medical and disaster planning professionals, avian influenza/bird flu hasn't disappeared - but it has dropped from the press' attention.

This report is a bit scary - Hong Kong found H5N1 virus in chickens in a crowded market area in the city. They authorities are moving quickly and are slaughtering a lot of birds. No people appear to have been infected - but crowded areas like this could be bad should the virus become more easily transmissable.