Recently in Health care Category

Diane raises a good point here about how there's a difference between a conservative wanting Obama to fail to institute his agenda and a conservative wanting America as a whole to fail. I buy that.

But what I struggle with is that Diane implies she's not sure that there was anything wrong with the Bush administration, speaking vaguely of "its mistakes, whatever those may have been." Diane then says that, by comparison, "our new President, he does not look so great."

I don't think that's a fair comparison. Conservatives have been saying that we can't judge Bush's legacy fairly for another generation, after we view its full impact. Yet they say Obama has been a colossal failure in, oh, about six weeks. Hmm. Aren't you willing to give Obama a whole generation before you judge him?

If he ends up getting the government to run health care the way it runs the post office, I'll happily hand him my support. Who do we want running health care -- AIG? General Motors?

Mariel wants us to leave Nadya alone. Fair enough. We skeptics are not planning on stalking her or locking her up. But just as she was free to do what she did, we're free to criticize a person with limited resources for hogging healthcare resources that are so precious that our new president considers it his top priority beyond the overall economy and national security.

I have many libertarian traits; my own blend could be described as a desire for a government that permits people to do anything and a culture that encourages people to do the right thing. Medical ethicists and talk-radio callers and all of us are correct to be discerning "what's right" here, even if it doesn't become a federal or state law.

I'm pro-choice, and that means a woman should have the choice to have no babies, or to have 14 babies if her body is up to it.

And that's the choice that Nadya Suleman, the Whittier mother of six who recently gave birth to octuplets, made when she found that all her fertilized embryos were viable. Apparently, her belief was that terminating them was killing them, and it was her right to make that choice.

Yet, people who know nothing about this woman have been weighing in on her character based on a few questionable facts, and concluding she's some sort of horrible person because she wants to raise a bunch of babies. Some have even suggested that she be prevented from having babies because of her mental state. Wow! Does anyone really want to start down the slippery slope of regulating who gets to reproduce?

No one should force a woman to make a choice about having or not having babies. That's what being pro-choice is all about. Besides, my grandfather came from a family of 22 kids, and he turned out ok.

So please, leave Nadya alone. She's got enough to worry about with eight preemies. And if you can't leave her alone, then at least send her a pack of Pampers.

To paraphrase the immortal words of the late, and therefore clearly mortal, Hunter S. Thompson, “I was somewhere around Encino on the edge of an urban jungle of strip malls when the drugs began to take hold.” I was on my way to conduct a class with a learned rabbi on Religion and Spirituality as my spirit and body seemed to want to part ways. Was I just getting in the mood or was there something non-spiritual afoot?

I was struck by a small epiphany, (so it didn’t hurt too much) and I realized that I was stoned—but not in a pleasant way. This was no flash back to the 60s when I may or may not have “experimented” with drugs. I love that euphemism experimented as if it were a lab section for a science class. The truth is I tried grass a few times and didn’t much like it. As someone who has struggled with weight issues (as well as weighty issues) all my life, if there is one thing I don’t need it is anything that encourages the munchies, or as my people say, noshing.

I was zipping along at 55 mph and feeling spacey, light-headed and sensed a slight tremor in my right hand. I asked myself if I felt safe to continue to drive another 45 miles to my speaking engagement. As one time sailor, I remembered my old safety rule: If I showed up at the dock and asked if the wind was blowing too hard for a recreational sail, it was. The question implied the answer. I pulled off the freeway and headed home.

At the time I did not know that it was the drugs. I thought that the head cold I was fighting had just weakened me, and I hadn’t put together what should have been obvious, and would have been obvious were I not stoned. The over the counter meds that the pharmacist had recommended for my head cold and sore throat had rendered me incapable of operating heavy machinery—which my little Honda CRV qualified as.

I returned home and not realizing it was the cough syrup (non-alcohol) and the anti-histamine, immediately took more meds before crawling into bed. Unsurprisingly I didn’t feel any better that night and after re-medicating in the morning nearly aborted a lecture in the first thirty minutes. I soldiered on to the end, returned home and did a web search of my two benign over the counter meds. I found that they could each make me light-headed, dizzy, drowsy and incapable of operating heavy machinery—such as my mouth. In combination they had, what is today called, a synergistic effect and rendered me non-compus mentis.

This is serious stuff, and I was totally unprepared to be, well, so totally impaired by non-prescription medication. During a long lifetime of allergies and three back injuries that led to surgeries, I have had a fair number of prescription medications and have never been so knocked out. I am deeply grateful (I suppose to myself) for my uncommon common sense in turning around and coming home.

My internal dialogue about how it was really nothing and I could still do it and how I mustn’t disappoint my audience seemed quite compelling at the time. Somehow I talked myself out of talking myself into continuing. Okay, that last sentence may indicate that I’m still suffering from some diminished capacity…but you do know what I mean.

The lesson, in case it isn’t clear, is that prescription drugs are not the only drugs that we should consider when assessing our ability to function. The over the counter market offers some pretty powerful drugs and they can and do alter thinking, reflexes and judgment—and these are the big three when operating a computer, a mouth or most importantly a car.

I give up. I have to confess to my conservative friends that they were right; I was wrong, and I have seen the light. Government is not the answer. It is the problem and capable of such remarkable stupidity that were I to pitch the following true scenario to Comedy Central, they’d laugh me out of the writers’ room.

We will all agree, left and right, liberal and conservative, that we have a health care problem. All of us local folks know that King Drew Hospital was a disaster with people stacked up in the hallways, lying on the floors and dying in the parking lot. Part of the reason was almost certainly the culture of the hospital, but some of the pain, suffering and death was caused by the amount of traffic. There were just too many people to be served efficiently or even decently.

Many poor people, often without private health care providers or insurance, used the hospital and its ER for everyday health care. This made the problem of triage, of serving the most critical folks in order of need, especially challenging. The hospital was failing.

So what was our local government’s answer to overcrowding and having people waiting for five hours to see a doctor? Well, you know the answer. It was to close the ER. A brilliant strategy. To paraphrase the famous mantra from Field of Dreams, “If you close it, they won’t come.” It follows logically as day the night that if they don’t come, then no lines. Therefore, if no lines, then no one dies in a closed waiting room.

This has been so successful with King Drew that their mortality rate has fallen to, well, zero. Buoyed by their success, the Feds are back into it again. They have just served notice to UCLA Harbor that their wait times are also unacceptably long and are threatening (Yes, you guessed right. Believe it or not!) to pull their accreditation and close them up, just like King Drew.

The logic is impeccable. The answer to overcrowding and long wait times is to close the hospitals. This also cuts down on mal practice and medical error. After all, if you don’t give them any treatment, they won’t get any mal treatment. If you don’t see them, they won’t be misdiagnosed. If they are not mistreated or misdiagnosed they won’t sue. We are saving lives and money all at the same time. We could end our medical care crisis in a minute if we just eliminated doctors and hospitals and didn’t see sick people.

Who comes up with this cruel, stupidly conceived and ill-considered absurdity? The answer, I fear, is government both local and federal. Not willing to leave bad enough alone, yesterday our local geniuses issued a plan to close our public health clinics. They hope that by closing publically run clinics they can get the non-profit private medical providers to step in. They believe the private sector will be happy to do it cheaper. They can hope. The private sector is already not thrilled with how Medicare, Medical and other government agencies pay. I’m sure they’ll be eager to assume a larger part.

However, what is certain is that by closing the clinics they will drive more poor and underserved to the ERs for ordinary health care. This will increase the wait times to see doctors, increase the financial losses of the ERs, drive more of the private providers out and increase the number of poor who die in waiting rooms, on floors and in parking lots. It’s brilliant. It is our government at work.

My problem in swearing off government being the answer is that if public agencies can’t help and the private sector won’t, I guess the poor will just have to go somewhere out of sight and die.

As my wife, The Fair Helenkela, lays in the recovery room, after receiving a new bionic knee, I am meditating (if in a somewhat agitated state) on the subject modern aging. I am also wondering why my wife, whose weight is appropriate, who works out three days a week, who has the heart of a 25 year-old has to contemplate a future with a hip replacement, hand surgery for arthritis and the other knee?

When I think of our parents’ generation, I am clear that we are in much better shape. We are not nearly as old as our parents were at our age. They were over weight, out of shape and in terrible cardio-vascular condition. Many were even dead.

We, on the other hand, have been into health for decades. Sometime after the excesses of the infamous 60s, when we turned 30, we gave up one set of drugs, stopped smoking cigarettes and started running—even without being prompted by cops with tear gas and batons. We went on hikes with the Sierra Club. We swam in Masters competitions. We joined gyms—and occasionally showed up, sometimes got past the café and actually worked out. We played golf, did aerobics, yoga and Tai Chi. We meditated. We got personal trainers.

We worked diligently at not becoming our parents. We went so far as to actually put on leotards. We bought Lycra for biking and skiing. We dressed, not in the grown up clothing of our successful elders, but in the style and fashion of our children. If any generation could fool mortality, it would be ours. Such was our vanity.

We gave up red meat. We force-fed ourselves fiber. We eschewed the chewing of fatty and deep fat fried foods. We are now buying organic. I do ask myself what an inorganic apple might be.

In order to follow up these healthy ways of trying to stay the aging process (which acts more like a processor—chewing us up) we got our faces lifted, our tummies tucked and our fat sucked.

The problem is that in trying to stay young and healthy, we’ve wrecked ourselves. Our moving parts aren’t moving so well and are in need of replacement. Part of the crisis in healthcare is that my cohort is worn out and out of warranty.

As one of the balladeers of my generation, Leonard Cohen, wrote/lamented, “Well my friends are gone and my head is gray. I ache in the places where I used to play.”

The philosopher Richard Cumberland wrote, “It is better to wear away than to rust out.” I think this is true. G-d knows we’re doing our best not to get rusty, but our maintenance and up-keep are becoming both fiscally expensive and physically painful. Still, my wife is looking forward to returning to the gym, getting back on our tandem bicycle and remaining active in life.

No, we won’t succeed in staying aging permanently. We will do our best to slow it down. Nor will we fool death with our beautiful bodies, youthfully lifted faces or even the inner health of aerobically exercised hearts and lungs. We will not live forever. We will, however, try our best to live fully as long as we’re alive.

Note: The Fair Helenkela came out of surgery wonderfully and is resting comfortably in the arms of Morpheus.

Well, we knew the earlier presidential primary would elevate California's importance in this year's elections, and now we're seeing the fruits. The California Nurses Association has been running this radio spot, ostensibly aimed at the Schwarzenegger-Nunez health plan, that just so happens to feature ... Barack Obama.

That's clever. The ad serves two purposes at the same time -- opposing the health-care reform and boosting the Illinois senator's presidential bid, yet the former purpose inoculates it from federal campaign-finance regulations. This way, the union can effectively make unlimited contributions to the Obama campaign. Smart.

Meanwhile, Obama has received the endorsement of State Sen. "One Bill" Gil Cedillo. Which is curious, seeing that Cedillo's singular concern is getting driver's licenses for illegal immigrants -- a policy Obama (says he) opposes. You'd think Cedillo would have backed Hillary, who supports the licenses, at least when she doesn't oppose them.

All the while, Los Angeles Mayor Antonio Villaraigosa is flitting around the state and the nation campaigning for Hillary. I guess the Clinton campaign figures between Hillary's appeal to put-upon women and Antonio's appeal to cheating men, they've got all their bases covered.

That's politics -- and we're about to get a massive dose of it.

So Delta Dental originally refused to pay for my wisdom teeth removal, somehow suggesting that the experience was recreational and not absolutely completely necessary. My oral surgeon sent Delta x-rays and a narrative explaining that, yes, it was necessary. So Delta finally paid -- but only for the cost of removing the teeth. They didn't cover any anesthesia, which in my case was cheesy, inadequate novocaine because they couldn't find a vein on my zombie-esqe body to use IV sedation. Who knew that in the world of dental insurance we have to bring our own bottles of brandy to surgery to try to numb the pain?

In today's Daily News, Geri Jenkins of the California Nurses Association takes a page from John Edwards, and uses the death of Nataline Sarkisyan to make the case for socialized medicine:

Every politician who thinks the solution to our health-care crisis is to mandate everyone purchase insurance products should stop and think about Nataline Sarkisyan. Her family was "covered" and "insured." And it didn't matter. They were denied care in the interest of Cigna profits. They deserved health care but got Cigna-care.

The California Senate, which will consider the Schwarzenegger-Nuñez bill later this month, has a variety of serious issues to consider, including the uncertain funding for the bill at a time when the state is facing a $14 billion deficit and the administration is already talking about cuts in current health programs.

Still it's important to know there is an alternative bill, one that has already passed the Senate, and will be considered in the Assembly in the coming months: Senate Bill 840, authored by state Sen. Sheila Kuehl, D-Los Angeles. It's similar to the system that exists in every other industrialized country and looks a lot like what we have with Medicare, only expanded and improved and covering everyone.

Under SB 840, doctors - not insurance companies - decide what medical treatment patients need. The profit motive to delay or deny is eliminated.

Isn't that the health-care system Nataline deserved and that all Californians should have?

Well, maybe, but it's not the health-care system SB 840 would deliver. Jenkins operates under the myth of the free lunch -- the erroneous belief that when a "single payer" (read every taxpayer in the state) is paying for health care, health care becomes unlimited, and every patient gets whatever treatment his or her doctor recommends.

But real-life socialized medicine doesn't work that way. Instead of insurance companies deciding who gets what care, government boards do it. (Indeed, when devising her national health plan, Hillary Clinton convened a whole panel of philosophers to discuss how best to ration medical treatment.) And in the place of the profit motive, we get the politics motive, the ideology motive, the special-interest motive, the inept bureaucracy motive, and the who-has-the-best-connections motive.

One can argue, I suppose, that this is an improvement over what we have now, but let's not pretend that scarcity, tough choices, and harsh denials would cease to exist under the socialized model. Far from it. In "every other industrialized country," there are also guidelines as to which treatments get covered, and which ones get denied, regardless of what the physician recommends. There are also often major shortages and long waits for basic medical treatment.

Horrific and tragic though the Nataline Sarkisyan story is, there's no guarantee that under a socialized system her liver transplant would have been approved. And even if it were, she likely wouldn't have survived the long wait for a surgeon.

When it comes to health care, there are no easy answers -- and there are always trade-offs.