Is That All You've Got?

2009-11-16T08:10:00.001-06:00

I'll be off blogging for a bit; just letting you know so you're not wondering.

Better Start Saving Now...

2009-11-11T14:31:00.005-06:00

I've never really fallen in love with a wallpaper before, but ohhhhhhhhhhhhh:

Is this what home ownership will be like? Curse you, Hygge & West, and your beautiful home goods! It looks like I'll be saving my allowance money for the next few months.

At least you're a local company. So there's that.

UPDATE: I've ordered a swatch. Maybe that will satiate me. I hope.

Health Care/Reform Roundup, Nov. 11: Veterans' Day

2009-11-11T13:53:00.000-06:00

The best

Congress considers help for families of injured service members (NPR, Nov. 7)

DANIEL ZWERDLING: Imagine this nightmare: Your son or your daughter is badly wounded in Iraq or Afghanistan, and luckily they're alive. But when they get out of the hospital they need somebody to take care of them, maybe for months, maybe for years, or forever. You don't want to send them to a nursing home, probably, right? So you say, okay, I will take care of my loved one. But that basically means you, Scott, are going to have to give up your former life to be a 24-hour nurse.
SIMON: And the government does not provide assistance to families in that position?
ZWERDLING: It does, but the families say nowhere near enough. Now, the government gives the most help if the vet is totally incapacitated. For instance, I met a young man a couple of weeks ago near Tampa, Florida. Part of his head was blown off by a grenade. He can't walk, he can't talk. His mother has to change his diapers, do everything for him.
If your son is like that, then the VA will pay you roughly $100,000 a year. And if the vet or the guardian says it's okay, your family can use that money to hire help to take care of them.
SIMON: Does that cover everything?
ZWERDLING: Well, no. I called a home healthcare agency the other day. They said this would cover basically just care during the day, okay? So let's say you're the vet's father. Here's your choice: do you want to keep working at your usual job while some home healthcare aides take care of your son during the day? Okay, that's fine. But then you come home at night and you have to then become the overnight nurse - you'll be totally exhausted. Or do you want to take the $100,000 and use that to pay your family's bills, but then you will take care of your son yourself 24 hours a day?

Painful stories take a toll on military therapists (NY Times, Nov. 7)

Major Hasan was one of a thin line of military therapists trying to hold off a rising tide of need. So far this year, 117 soldiers on active duty were reported to have committed suicide. The Army has only 408 psychiatrists — military, civilian and contractors — serving about 553,000 active-duty troops around the world. As a result, some soldiers home from war, suffering from nightmares and panic attacks, say they have waited almost a year to see a psychiatrist.
Many military professionals, meanwhile, describe crushing schedules with 10 or more patients a day, most struggling with devastating trauma or mutilated bodies that are the product of war and the highly advanced care that kept them alive.
Some of those hired to heal others end up needing help themselves. Some go home at night too depressed to talk to their children. Others, like Bret A. Moore, a former Army psychologist at Fort Hood, ultimately quit.
“I planned for a career in the military, but I burned out” after about five years, he said.

The rest

An open-source approach to better prosthetics (NPR, Nov. 10)
Rough road for military families with special needs (NPR, Nov. 7)

The other rest

What does the House bill mean for Minnesota? (Minnesota Public Radio, Nov. 11)
Maybe now we'll finally see some more definitive action on the BPA thing, eh? High BPA levels linked to male sexual problems (Washington Post, Nov. 11)
Poor nutrition 'stunting growth' (BBC, Nov. 11)
New warning on 'perfect vaginas' (BBC, Nov. 11)
President Clinton urges Senate action on health care (LA Times, Nov. 11)
'No fasting' for cholesterol test (BBC, Nov. 11)
Health care vote pits Democrat vs. Democrat (Politico, Nov. 10)
First wheelchair-accessible taxis to hit DC streets (Washington Post, Nov. 10)
'Opt out' proposal puts state leaders to the test (NY Times, Nov. 10)
Maine finds a health care fix elusive (NY Times, Nov. 10)
Economic scene: Falling far short of reform (NY Times, Nov. 10)
South Florida man's battle with health insurance inspires 'Ian's Law' (McClatchy, Nov. 10)
US health care sector is a fairly green giant (AP, Nov. 10)

Wishful Thinking...

2009-11-11T12:04:00.004-06:00

I have two wonderful friends who are kicking ass and taking names in Africa right now, working in public health, and saving lives on a daily basis.

Me, I'm sitting in my office, staring at the traffic go by, and writing issue briefs about uninsurance levels and federal funding.

I know I'm helping people get insurance, and then get care, and then get healthy. I even know who those people are, sort of--at least, I know in theory what populations we're covering. But I can't see their faces, and it all seems sort of amorphous (again, today, with the amorphous!), and it's easy to forget that I'm helping people.

So I'll stick with it, and keep volunteering, and keep reminding myself I really don't like interpersonal interaction anyways...

I'd imagine it'll get much harder to read my friends' blogs once the sun goes away for the winter, here in Minnesota. Which is about next week, right?

Possessive Apostrophes & 'S'

2009-11-11T10:34:00.007-06:00

Fun fact of the day regarding apostrophe use, from the AP Stylebook. I totally didn't know the rule about the following word starting with s, or about the whole proper noun thing. You learn something new every day:

SINGULAR NOUNS NOT ENDING IN S: Add 's: the church's needs, the girl's toys, the horse's food, the ship's route, the VIP's seat

SINGULAR COMMON NOUNS ENDING IN S: Add 's unless the next word begins with s: the hostess's invitation, the hostess' seat; the witness's answer, the witness' story

SINGULAR PROPER NAMES ENDING IN S: Use only an apostrophe: Achilles' heel, Agnes' book, Dickens' novels, Moses' law

PLURAL NOUNS NOT ENDING IN S: Add 's: the alumni's contributions, women's rights

PLURAL NOUNS ENDING IN S: Add only an apostrophe: the churches' needs, the girls' toys, the horses' food, the ships' wake, states' rights the VIPs' entrance

Why?

2009-11-11T10:01:00.003-06:00

Alright, you wonks: Why is a Blue Ribbon Task Force called a Blue Ribbon Task Force?

This isn't trivia. I really don't know the answer, and the amorphous beings that know all, Google and Wikipedia, aren't helping me. So you, Interwebs, third omnipotent amorphous being--you help.

Health Care/Reform Roundup, Nov. 10:

2009-11-10T11:39:00.007-06:00

So, clearly, the big news is that the House has passed health reform. And it includes a public option. Which makes my wonky little heart sing.

However, as a student of feminist philosophy and liberation theology, the amendments restricting abortion among low-income women is pretty devastating. This sounds melodramatic, but I don't mean it to: Sometimes I wonder whether I'll live to see the day that politicians demonstrate their respect for low-income women (often of color) through just legislation. It feels like I'm banging my head against a wall. Or my vagina against a wall. It would probably hurt more.

So today's roundup is in celebration of health reform, which is a truly amazing, historic event, and in anger and frustration at Congress's inability to acknowledge that women (or people without money, or gays and lesbians, or people of color, or...) are truly people who deserve rights to health care.

The best

Abortion was at the heart of wrangling (NY Times, Nov. 7)

It was late Friday night and lawmakers were stalling for time. In a committee room, they yammered away, delaying a procedural vote on the historic health care legislation. Down one floor, in her office, House Speaker Nancy Pelosi desperately tried to deal with an issue that has bedeviled Democrats for more than a generation — abortion.
After hours of heated talks, the people she was trying to convince — some of her closest allies — burst angrily out of her office.
Her attempts at winning them over had failed, and Ms. Pelosi, the first woman speaker and an ardent defender of abortion rights, had no choice but to do the unthinkable. To save the health care bill she had to give in to abortion opponents in her party and allow them to propose tight restrictions barring any insurance plan that is purchased with government subsidies from covering abortions.
The restrictions were necessary to win support for the overall bill from abortion opponents who threatened to scuttle the health care overhaul.

Breaking down abortion language in health care bill (NPR, Nov. 9)

Government Money: In general, government money cannot be used to pay for abortion. The government-administered health plan — often called the public option — will not cover abortion, unless a doctor certifies that a woman is in danger of death without one, or the pregnancy is the result of rape or incest.
If you get your health insurance through the government, or with help from the government in the form of a tax subsidy, your plan will not cover abortion. In this case, you would have the right to buy extra coverage — with your own money.
If you get your health insurance through your state, as in Medicaid, your state could buy supplemental abortion coverage for everyone it insures. And 17 states already do this under Medicaid.
The Exchange: The next section of the abortion amendment deals with the exchange. That's the government-administered service where people can buy insurance and join a risk pool. One of the reasons health care is so expensive for people who don't get it through their work is that they're not in a large risk pool. The bill tries to group them together and cut costs for everyone.
Private insurance companies that offer a health plan through the exchange are allowed to cover abortion. But if they're going to, the companies must also offer another plan that is identical in every way, except that it does not cover abortion.
So, say you're buying insurance with your own money, and you get it through the exchange. You can choose a policy that covers abortion, or one that doesn't. But if you're getting help from the government to buy that insurance — in the form of a tax subsidy — you may not choose a plan that covers abortion. You are still allowed to buy a supplemental policy with your own money.
Private Insurance: The Stupak amendment does not apply to private insurance bought with private money. It is also not close to becoming law. The Senate bill does not have similar language, though lawmakers on both sides of the debate are now looking at it.
The question now is how this might play out in a whole new medical system, and what it means in the broader narrative of abortion in America.

Painful compromises (The 19th Floor, Nov. 8)

Congress made a little bit of history last night when the House passed a comprehensive health care reform bill. The vote was closer than I'd like to see, but it creates significant momentum towards final passage. And abortion, not the public option, proved to be the issue that almost killed the bill in the end. The resulting compromise is terrible public policy motivated by the worst kind of paternalistic sexism. It prohibits lower-income women from accessing abortion services on the exchanges to be created under the bill, including private insurance policies. Of course, women of means will still be able to get abortions without any restrictions.

I understand that the pro-life movement has deep feelings on this issue, but their actions in this most recent debate demonstrate a really distasteful form of classism. Federal law already restricts women on Medicaid from receiving abortions, but this provision extends that prohibition to private insurers. As a society, we seem to have a fondness for complicating the lives of people in poverty as much as possible.

Final negotiations between the House and Senate may result in a less draconian provision, but I'm not optimistic. Overall, this is still a really good bill and it will help millions of people. Those of us who believe in abortion rights may just have to increase our donations to Planned Parenthood.

As it relates to reform

Sweeping health care passes House (NY Times, Nov. 7)
House passes health care overhaul (NPR, Nov. 7)
US backs health care reforms (BBC, Nov. 8)
Democrats raise alarm over health bill costs (NY Times, Nov. 9)
For left, House bill may be as good as it gets (Politico, Nov. 10)

The rest

I know, it's a LOT. I was out of commission yesterday.

Wearing a pedometer can can be a big step in the weight-loss battle (Washington Post, Nov. 12)
Indiana clinic lets patients work off bills (NPR, Nov. 10)
Doctors' group votes to lobby of repeal of military's 'don't ask, don't tell' policy (AP, Nov. 10)
Retiring 'is new lease of life' (BBC, Nov. 10)
WHO: AIDS leading cause of death, disease for women of child-bearing age (AP, Nov. 9)
Above: A widow paints a health care protest (NPR, Nov. 9)
Republicans take aim at vulnerable Democrats in health war (Politico, Nov. 9)
Monday 'most common for sickness' (BBC, Nov. 9)
The claim: Magnetic therapy can ease arthritis pain (NY Times, Nov. 9)
Test improves Alzheimer's diagnosis (BBC, Nov. 9)
'Singing helps my lung problem' (BBC, Nov. 9)
Bill would limit needle exchanges (NY Times, Nov. 8)
Louisiana Republican breaks ranks on health care bill (NY Times, Nov. 8)
Will Washington State's experiment work for the nation? (NPR, Nov. 7)
Heavier Americans push back on health debate (NY Times, Nov. 7)
Findings inconclusive on teaching abstinence (Washington Post, Nov. 7)
Considering values in the health care debate (NPR, Nov. 6)
My favorite from the past few days: Experts map the body's bacteria (BBC, Nov. 6)
10-year project to reduce heart attacks in New Ulm shows promise (St. Paul Pioneer Press, Nov. 6)
Bellevue natural birth center, haven for poor women, closes (NY Times, Nov. 6)
In anxious times, medical help for the mind as well as the body (NY Times, Nov. 6)
Babies may pick up language cues in the womb (NPR, Nov. 6)
Needy GAMC patients to get coverage under MinnesotaCare, state decides (St. Paul Pioneer Press, Nov. 6)
Research shows neighborhoods where AIDS treatment lags (NY Times, Nov. 5)
Tiny tech sparks cell signal find (BBC, Nov. 5)
The high price of being a gay couple (NY Times, Oct. 2)

Yes, I'll Take Your Job, Now That Youv'e Made Me Feel Completely Worthless. COME ON!

2009-11-09T10:19:00.003-06:00

Dear People Who Interviewed Me in July for a Job:

If you really wanted to hire me for said job, you probably should've let me know IN JULY WHEN I FOLLOWED UP WITH YOU, rather than never responding, not calling, and then mass e-mailing all of your interviewees to let them know you're still hiring.

Now--being that it's November--I've sorta moved on, and I can't say I'm really interested in your job. In fact, I feel pretty stupid now for being excited for your job in the first place. But I'm sure I could contact all of my fellow interviewees for some moral support, being that I now have all of their e-mail addresses.

Also, thanks for your promptness. Makes me feel super-special.

Ugh. COME ON.

Love,

Me

Why Do I Blog, Indeed

2009-11-08T09:54:00.003-06:00

Check it:

A day in the life: Who is Minnesota? (St. Paul Pioneer Press)

Aside from the Hyundai commercial, this is as close as I'll ever get to my 15 minutes.

So if you're here from the Press, welcome. If you think all of this health care business is boring, check out some of my other friends in Minnesota, who are far more eloquent (and often more interesting) than me:

Minnesota Gal (http://minnesotagal.wordpress.com/): Sarah grew up in good ol' St. Paul, and she and her husband now currently live in the Philippines while he works for the American Foreign Service. Sarah's writing is so ridiculously vivid, I feel as though I'm there in her apartment, hogging her brand new chaise lounge while she navigates life in the Philippines for me.
The 19th Floor (http://www.the19thfloor.net/): Mark's blog is the hardest for me to describe. It really is a day-in-the-life type of blog, but his day in the life always seems a little more interesting than mine. Add his eloquence and his brevity, and you've got one of my favorite blogs. And, every once in a while, he gets a little wonky about the healthy policy. I love wonky health policy.
Problem Girl (http://newbabynews.blogspot.com/): If I had to read one blog for the rest of my life, it might be this one. Jen blogs about life as a mum, life as a surrogate mum, and being a mum to an Aspie, but does it with a panache I can only hope to someday achieve. For example:

Private Parts

When Joseph was little he was, as most little boys are, fascinated with what he had going on in his pants. He wasn't shy about it either. To solve this we intoduced him to the concept of "private parts". We told him those were his private parts and if he wanted to touch them he could do it when he was alone because it polite to do it in front of other people. We also used it as a "bad touch" teaching moment. He shouldn't be showing his to anyone, no one should be showing him theirs. It was a good, simple, concrete concept that really seemed to work for Joseph.

It worked so well in fact that I decided to have the same conversation with Elle recently. She seemed to take it to heart too.

Maybe too much so.

Yesterday Elle and I ran to the grocery store to pick up a couple of things. She kept trying to run away from me and dart into different aisles. That's very unlike her since she's usually glued to my side begging me to buy her stuff when we grow grocery shopping. At one point I was at the end of an aisle and she way way at the other end. We treated the two older ladies between us to this conversation.

Me: Elle, come back over by me.
Elle: I can't! I have to go to the next aisle!
Me? Why baby?
Elle: Because I have to touch my privates and I need to be alone to do it!

Turns out the poor kid had an itch to scratch and she was trying desperately to find somewhere she could be alone and take care of it.

Sigh.

At least I know she's listening to me.

So give them some love, and come back every once in a while. I promise I'll give this health care roundup thing a rest when we get some legislation passed.

Do It: Carmina Burana, Lab Theater, Minneapolis

2009-11-05T21:49:00.005-06:00

...You know how dudes are always like, "If I had boobs, I'd sit and play with them all day and never leave the house"?

If I had Bradley Greenwald's voice, I'd sit and listen to myself sing all day, and never leave the house. I'd be a complete hermit.

Carmina Burana was a delight. It was beautifully danced, and the musicians were impeccable (I could've used a little more high end in the orchestra). And the soloists, natch, were quite lovely. And Bradley Greenwald was revelatory, as usual. Can something be "normally revelatory?" Or can a revelation, by definition, only happen once? Eh, whatever. He was pretty darn nice.

Go see Carmina Burana at the Lab, if you get the chance; it's on through Sunday. It's like watching an hour and a half of Rodin in motion, with beautiful music to boot. Who wouldn't want to see that?

List

2009-11-05T15:41:00.002-06:00

1. Cannot believe I haven't yet mentioned my deep and abiding love for one Bradley Greenwald on the blog yet.

2. Going to see Carmina Burana at the Lab tonight, with said Bradley Greenwald. Have somehow convinced my husband this is a good idea.

3. Oh, my goodness, Carmina. And Bradley Greenwald. And dancers in flesh-colored unitards. The stars are aligning.

Health Care/Reform Roundup, Nov. 5: That Clinking, Clanking Sound...

2009-11-05T09:42:00.015-06:00

Wow, there's a lot today. Pretty hard to pare it all down, so you get it all. Today's mostly money stuff.

To make a long story short: We're probably going to enact health reform, but it won't quite be the right health reform because we're still working within an employer-based system, and it'll be really damn expensive health reform. Which is totally worth it or the seventh sign of the apocalypse, depending on which side of the aisle you reside.

The best

Health bills too timid on cutting costs, experts say: Proposals make only trims where broader changes are needed, critics argue (Washington Post, Nov. 4); Blog: Overhaul may boost coverage, but what about costs? (NPR, Nov. 4)

You can put me on the record as saying we need to do much more in terms of comparative effectiveness. From the Washington Post:

Overall, Democratic lawmakers have turned to "tried and true" strategies for reducing spending that merely ratchet down payments rather than fundamentally changing how the health-care system operates, said Drew Altman, head of the nonpartisan Kaiser Family Foundation.

More than $110 billion worth of Medicare "savings," for example, simply comes from a cut in reimbursements to insurers that run the private Medicare Advantage program, and much of the $80 billion extracted from drug companies is in the form of higher Medicaid rebates to the government. Both proposals would reduce costs but have little to do with fundamentally refashioning health care.

What's more, Congress has a history of reversing itself on politically unpopular cuts, so it is risky to count on those savings, Altman said.

Unlike past reform efforts that barely gave a nod to tackling double-digit medical inflation, the bills this year "have some of the right rhetoric," but they fall short of real-world applicability, said Jack Lewin, chief executive of the American College of Cardiology. Without significant financial incentives and strict deadlines, he predicted, few doctors would rush to move toward the coordinated-care models reformers say are needed to save money and maintain high quality.

Ralph Neas, head of the nonpartisan National Coalition on Health Care, noted that "these bills do very little in terms of reining in long-term cost growth," adding: "There is not enough in the public sector and virtually none in the private sector."

* * *

"Voluntary efforts are never enough," Neas said. "There has to be some way to make it enforceable."

Richard Foster, the chief actuary of the federal Centers for Medicare and Medicaid Services, said lawmakers could achieve far greater savings in the health system if they aggressively pursued research that identifies the best, most cost-effective treatments.

"If you did comparative effectiveness in a way that looked at whether to approve a new therapy because it is cost effective and is an improvement, then you'd have a fighting chance of slowing down the rate of growth," he said in an interview. "Nobody's proposing that."

Opinion: Some vaguely heretical thoughts on health reform (New Yorker, Nov. 4)

A well-taken point, although I'm not sure I agree with his math. But read the whole thing; the clips below don't work as well as the whole.

I regard an expansion of the government safety net as ethically essential, economically justified, and long overdue. It is indefensible for a country as rich as the United States to fail to provide adequate health care for many of its citizens. In extending our health-care system, all we are doing is catching up with Otto Von Bismarck’s Germany, which recognized a hundred and twenty-five years ago that universal health and disability coverage, along with old age pensions and a system of public education, were essential elements of a modern society. Moreover, given the reluctance of “Blue Dog” Democrats, such as Nebraska Senator Ben Nelson, to support anything that smacks of big government, and President Obama’s determination to coöperate with moderate Republicans, the proposed reform may be the most that can be accomplished today. But we will be dealing with its consequences for decades to come, and I think it’s important to be clear about what the reform amounts to.
* * *
The Pelosi bill, in particular, wouldn’t do much, if anything, to address the overall escalation in health-care costs, much of which is rooted in the nature of insurance, where individuals consume costly health services, and different people—the other members of their risk pool—pay for them. This is the “moral hazard” problem that the economist Kenneth Arrow identified as long ago as 1963. (For an easy-to-understand account of Arrow’s argument, see his riveting on market failure.) In the past twenty years, many ideas have been have been tried in the effort to restrict the growth of spending within a private insurance system, the most notable of which was the creation of H.M.O.s. Some have enjoyed temporary success. None have worked for long.

'High spending but lagging quality' in US health care (AFP, Nov. 5)

If you don't know this yet, we should really have a talk.

Despite spending more than twice as much as other developed countries, the United States still lags behind in terms of access and quality, an international survey said Wednesday.
Insurance restrictions and health care costs make US patients more likely than people in 10 other countries to struggle to receive treatment, according to the annual survey of over 10,000 primary care physicians.
"We spend far more than any of the other countries in the survey, yet a majority of US primary care doctors say their patients often can't afford care," said lead author Cathy Schoen, senior vice president of the Commonwealth Fund.
Some 58 percent of primary care doctors in the United States said their patients have trouble paying for care and medication, compared to five to 37 percent in the other countries.
The study, published in the journal Health Affairs, comes as US President Barack Obama faces a pitched and prolonged battle in Congress over his plans to reform the country's health care system.

Opinion: The President should be opposing the House bill (Kaiser Health News, Nov. 5)

Wait--Peter Orszag blogs? ...Doesn't he have more important things to do?

The president spent much of the first half of this year promising that a health care plan would "bend the cost curve." Last week, White House Budget Director Peter Orszag stated in a blog post on the Office of Management and Budget Web site that the administration is banking on two provisions to bring about this dramatic slowing of the escalation of health care costs. The first is the suggested new tax on high-cost insurance plans. The Senate Finance Committee approved a provision to impose a tax on plans with premiums exceeding $8,000 for single coverage or $21,000 for family coverage. By all accounts, the incidence of this new tax will largely fall on high-cost insurance enrollees, which is why union opposition is intense. The second provision would empower an independent commission to propose and implement payment reforms in Medicare. There are real questions about whether these provisions are the "game changers" claimed by administration officials. Regardless, neither is in the House bill. The House did include an independent review of regional disparities in Medicare payment structure, but the mandate is very limited, and certainly is not aimed at cost control. CBO estimated the provision would have no effect on the federal budget.

So what does the House bill do to cut costs? Orszag touts the inclusion of more bundled payments, incentives for hospitals to cut back on preventable readmissions, and other similar changes. But these are minor adjustments that are doomed to get watered down as time passes. In the main, the House bill would simply reduce payment rates in Medicare and Medicaid to save money, including large cuts in reimbursement levels for hospitals, nursing homes, and home health agencies. These cuts are not calibrated to reward quality or encourage more integrated models of care. They are applied across the board. And they certainly do not constitute delivery-system reform. On paper, they appear to reduce Medicare's per capita cost growth rate. But if payment rates were the answer to the cost problem, it would have been solved long ago.

The rest

Amazonian tribe hit by swine flu (BBC, Nov. 5)
Family doctors' health messages to be brought to you by Coke, prompting outcry, resignations (AP, Nov. 5)
House expected to vote on health bill Saturday (Washington Post, Nov. 5); Dems want to seize historic moment (Politico, Nov. 5)
AARP expected to endorse House Dems' health bill (NPR, Nov. 5)
I knew it! I DID have the big pig flu! Blog: Feeling Flu-ish? It's more likely to be flu this year (NPR, Nov. 5)
Advocates for cancer patients decry waiting period; budget for high-risk pool seen as low (AP, Nov. 5)
Wow! Three million people! That's, like, SIX PERCENT OF THE PEOPLE WHO NEED IT, Republicans. Get a clue: Blog: House Republicans' overhaul would insure 3 million more people (NPR, Nov. 4)
Older bypass method is best, study shows (NY Times, Nov. 4)
Also: Larry Craig now SOL in hoping FEHBP will pay for his "special operation": Conservatives shop sex ops ban to GOP (Politico, Nov. 4)
Blog: Do you - *Achoo* - support health reform? (NY Times, Nov. 4)
Opinion: Unhealthy America (NY Times, Nov. 4)
Family history of little health use: Study finds collected data minor factor in medical care (Chicago Tribune, Nov. 4)
Editorial: Offer to teen girls - Don't get pregnant, get cash for college (Opposing Views, Nov. 1)

The ugly

Michele Bachmann to protesters: 'Scare' Congress (Politico, Nov. 4)

Health Care/Reform Roundup, Nov. 4

2009-11-04T09:00:00.002-06:00

The best

Conflict of interest for AARP in health bill debate? (NPR, Nov. 4)

Still, questions about the organization's finances have been raising eyebrows for years. And America's two main parties take turns being angry at AARP.
Speaking in 1995, Republican Sen. Alan Simpson said, "AARP has drifted considerably from any possible description of a nonprofit, quote, organization."
And in 2003, Democratic Rep. Maxine Waters said, "Don't forget, AARP is making a lot of money off of the insurance companies."
An Issue Of Trust
A recent public opinion poll suggests that none of those attacks has stuck.
The poll by NPR and the Kaiser Family Foundation listed seven of the biggest players in the health care debate and asked which one would recommend "the right thing for the country."
AARP easily led the list among Democrats and independents. Among Republicans, it tied for first with an option titled "health insurance companies."
So it's hard to tarnish AARP, in part because it's not seen as serving either an ideology or a narrow economic agenda.

The rest

House Republicans offer alternative health bill (NPR, Nov. 4); GOP counters with a health plan of its own (NY Times, Nov. 3); Blog: GOP health bill covers familiar ground (NPR, Nov. 3)
Senate moderates flex muscle on health care bill (Washington Post, Nov. 4)
Plan creates new program for long-term care (Wall Street Journal, Nov. 4)
Blog: 'Mom always liked you best' (NY Times, Nov. 3)
CHIP on chopping blog again? (Charleston [WV] Gazette, Nov. 3)
House bill would assure workers paid sick days (NY Times, Nov. 3)
Most health care careers don't offer an easy path (AP, Nov. 3)
Health care debate focuses on legal immigrants (NY Times, Nov. 3)
Depression linked to processed food (BBC, Nov. 2)
Opinion: Think only 'their' teens get pregnant? (Baltimore Sun, Nov. 2)

Health Care/Reform Roundup, Nov. 3: Half of All American Kids Will Receive Food Stamps at Some Point During Childhood, Study Says

2009-11-03T09:10:00.006-06:00

The best

Half of all American kids will receive food stamps at some point during childhood, study says (AP, Nov. 2)

Nearly half of all U.S. children and 90 percent of black youngsters will be on food stamps at some point during childhood, and fallout from the current recession could push those numbers even higher, researchers say.

* * *
The time span included typical economic ups and downs, including the early 1980s recession. That means similar portions of children now and in the future will live in families receiving food stamps, although ongoing economic turmoil may increase the numbers, Rank said.

The rest

Chambers seek common ground on health care (Politico, Nov. 3)
Abortion language creates snag for health bill (NPR, Nov. 3)
Health care provision seeks to embrace prayer treatments (LA Times, Nov. 3)
List leak leads to murky vote count (Politico, Nov. 3)
Medicare experiments to curb costs seldom implemented on a broad scale (Kaiser Health News, Nov. 3)
New vaccine offers chance for children in Africa, where 1 million die of malaria each year (AP, Nov. 3)
Hospitals cite worry on fees in health bill (NY Times, Nov. 2)
The claim: A person can pay off a sleep debt by sleeping late on weekends (NY Times, Oct. 2)
A powerful identity, a vanishing diagnosis (NY Times, Nov. 2)
A marathon run in the slow lane (NY Times, Nov. 2)
Designing a safer cigarette (Forbes, Oct. 26)

Health Care/Reform Roundup, Nov. 2: States Likely to Shape Health Reform

2009-11-02T09:31:00.003-06:00

The best

States likely to shape health reform: Many choices up to them (Washington Post, Nov. 1)

Given that the Senate presents the larger political hurdle to passing legislation, political analysts expect its state-choice approach to prevail. That means that a White House signing ceremony for a health-reform bill could become a prelude to 50 state legislative battles over how to expand Medicaid, how to set up the exchanges and how to enforce new insurance regulations, as well as whether to give state residents access to a public plan.

"Everybody forgets that you pass the legislation and that's really just the first part. There are years of rulemaking and negotiations and lobbying over the regulations and the implementation," said Joan Henneberry, health policy adviser to Colorado Gov. Bill Ritter (D).

Henneberry and her colleagues across the nation are following congressional negotiations closely, scanning the shifting ground for clues about the role of the states, particularly regarding Medicaid, the state-run health program for the poor that could be expanded to cover as many 15 million additional people. Most, but not all, of the extra money would come from Washington, and states are likely to face myriad other post-reform costs, particularly if they have to hire administrators to run the exchanges.
Can they manage it?

Health policy experts are concerned not only about the ability of the states to shoulder their share of the cost of reform but also about their administrative and analytical capacity.

Some states are well-positioned to manage a new federal program that seeks to cover the uninsured while pressuring doctors and hospitals to deliver care more efficiently. Minnesota, for example, has long offered quality health care at relatively low prices, thanks to nonprofit insurance plans, group health insurance and managed-care programs.
* * *
At the other end of the spectrum are states with poor collaboration in the health sector, lax insurance regulations and small, disorganized Medicaid programs, said Alan Weil, executive direction of the National Academy for State Health Policy. Because such states also tend to have large populations of uninsured people, they could find the post-reform transition particularly harrowing.

The rest

A who's who of health care reform (Politico, Nov. 2)
Opinion: Take this conservative argument seriously (Kaiser Health News, Nov. 2)
GOP set to propose its own health bill (Wall Street Journal, Nov. 2)
Analysis: Public option might only play minor role in changing health care (Kaiser Health News, Nov. 2)
Indoctrinating doctors? Alternative medicine goes mainstream at some med schools (AP, Nov. 1)
Obama strategy on health legislation appears to pay off (NY Times, Nov. 1)
'Public option' divides Franken, Klobuchar in health care debate (St. Paul Pioneer Press, Oct. 31)
Axelrod on H1N1 vaccines: 'We over-promised' (NPR, Oct. 31)
Opinion: Supply-side ideas, turned upside-down (NY Times, Oct. 31)
Women at arms: A combat role, and anguish, too (NY Times, Oct. 31)
Let me tell you, if my corner store started stocking good produce, I'd be all over it: Pushing fresh produce instead of cookies at the corner market (NY Times, Oct. 30)

Health Care/Reform Roundup, Oct. 30: As Donors Focus on AIDS, Child Illnesses Languish

2009-10-30T08:35:00.001-05:00

The best

As donors focus on AIDS, child illnesses languish (NY Times, Oct. 29)

His observation lies at the heart of a wider debate over whether the United States and other rich nations spend too much on AIDS, which requires lifelong medications, compared with diarrhea and the other leading killer of children, pneumonia, both of which can be treated inexpensively.
The debate is flaring at a time of great opportunity and risk. Recent data has documented remarkable progress in reducing child mortality and treating people with AIDS. Foreign assistance, which has often delivered disappointing results, is helping save millions of lives, the new figures show.

* * *
In Africa’s two most populous nations, Nigeria and Ethiopia, the number of people who died of AIDS in 2007 — 237,000 — was less than half the 540,000 children under 5 who died of pneumonia and diarrhea. But this year, the $750 million the United States is spending on H.I.V. and AIDS in the two countries not only dwarfs the $35 million it is spending there on maternal and child health, but is also more than the $646 million it is spending on maternal and child health in all the world’s countries combined.
“AIDS is still underfunded, no question,” said Jeremy Shiffman, a political scientist at Syracuse University who has documented global health spending patterns. “But maternal, newborn and child mortality is a tremendous tragedy and gets peanuts.”

The rest

Washington-area TV station broadcasts demonstration of bare breast self-exams (AP, Oct. 30)
U vet school gets $55 million to study deadly pandemics (Minneapolis Star Tribune, Oct. 30)
Obama lifting ban barring people with HIV from entry into US, effective after New Year (AP, Oct. 30)
Duh: 17,000 child deaths linked to lack of insurance: Kids without coverage are more apt to die while hospitalized, study finds (US News & World Report, Oct. 29)
Awareness: On drug labels, vital facts may be missing (NY Times, Oct. 29)
States of sleeplessness: West Virginia leads nation in lack of shut-eye, CDC says (AP, Oct. 29)
Blog: Report backs White House claim of $700 billion in wasteful health spending (NPR, Oct. 29)
Some cry favoritism over Obama daughters' swine flu vaccination, others say it's a good example (AP, Oct. 29)
FACTBOX: Provisions of House health care legislation (Reuters, Oct. 29); Details on health care bills in House, Senate (AP, Oct. 30)
How the GOP hopes to overcome 'Party of No' (Time, Oct. 29)
'Americans first' before US donates H1N1 vaccine (Agence France-Presse, Oct. 28)
Sex, alcohol, fat among world's big killers - WHO (Reuters, Oct. 27)
Call to act on maternal mortality (BBC, Oct. 26)
Human rights want US leadership in fighting violence against women (VOA News, Oct. 23); Opinion: Halting violence against women in India and elsewhere a win-win (US News & World Report, Oct. 23)
Issue brief: The Community Living Assistance Services and Supports (CLASS) Act (Kaiser Family Foundation, Oct. 20)

Problem Solved!

2009-10-29T10:42:00.003-05:00

I've figured out my Halloween dilemma: Instead of handing out homemade candies (which I'm still pretty sad I can't do), we're handing out the usual Snickers/Skittles/Starburst mix, and also giving kids mini-bottles of hand sanitizer that they can clip to their backpacks and coats. Spread the Public Health word! Scrubba scrubba scrubba!

From Elmo to 'Happy Birthday' hand washing, kids learn their part in preventing spread of swine flu (AP, Oct. 28)

Health Care/Reform Roundup, Oct. 29: Grading the Public Options that Already Exist

2009-10-29T09:04:00.004-05:00

The best

Grading the public options that already exist (ProPublica, Oct. 28)

Pundits and politicians from both sides of the fence have been hollering themselves blue about a potential public health care option. Instead of relying on private insurers, the government would insure people itself. The idea is that if a government-run option were offered to compete with private insurers, it could help keep pricing in check and ensure quality.

Two of the three health care reform bills in Congress have a public option. What might a public option look like in practice? One way to find out is to look at what’s already out there. About a third of Americans already get health care from a publicly administered program.

The rest

Finance bill's fine print may cause sticker shock for some consumers (Kaiser Health News, Oct. 29)
Jury awards $1.25 million in death of Hibbing boy (Duluth News Tribune, Oct. 29)
House health care reform bill to include public option (Washington Post, Oct. 29); Most liberals can live with compromises (Politico, Oct. 29)
Opinion: A practical reform: Indian country as the 51st state (Kaiser Health News, Oct. 29)
Swiss government proposes restrictions on groups like Dignitas that offer assisted suicide (AP, Oct. 28)
Health experts say Russia's abstinence approach no match for fast-growing AIDS epidemic (AP, Oct. 28)
Massachusetts governor says US health plan must cut costs (Bloomberg, Oct. 28)
The New Old Age [Blog]: Limited mobility of another sort (NY Times, Oct. 28)
From Elmo to 'Happy Birthday' hand washing, kids learn their part in preventing spread of swine flu (AP, Oct. 28)
Myth: HIV/AIDS rate among black women traced to 'down low' black men (NPR, Oct. 28)
Blog: 23 web sites to help you figure out health care prices (Wall Street Journal, Oct. 27)

Oink

2009-10-28T11:52:00.001-05:00

So it turns out I might've had swine flu a few weeks ago, after all. After a weekend at the Metrodome at the beginning of October, I got the worst cold/flu/whatever I've had in about five years, and it lasted FOR-EV-ER, but felt like I should still go to work because I had no fever. And I was convinced (as was J) that no fever meant no swine flu. Silly me. So, clearly, the whole "no work/school for 24 hours post-fever" thing is up in the air a bit, no? So when IS it safe to go back to work?!

No fever may not mean no H1N1 flu (Minnesota Public Radio, Oct. 28)

Health Care/Reform Roundup, Oct. 28: Opting In, Out, Up, Down, Over, Under...

2009-10-28T09:04:00.006-05:00

The best

Opting out: Not as simple as it looks (Politico, Oct. 28)

It is a very American idea. Our founders established the notion of federalism to allow states that felt strongly about public policy to operate under different laws and procedures. Currently, states have broad latitude to set their own rules in areas such as insurance, education and welfare. Indeed, state-level differences are so widespread that the late University of Chicago Professor Morton Grodzins described America as having a “marble cake” federalism with complex textures and contradictory policies.

On the surface, the public insurance opt-out appears to solve a number of political and philosophical problems. By being acceptable to progressive representatives and palatable to moderate legislators, the idea offers the obvious advantage of legislative coalition building. It is easier to sell the idea of a public option if people know their state does not have to participate. This compromise allows areas that are philosophically or otherwise opposed to the government offering a public insurance option to decline to participate in that system.

But there are serious logistical questions in terms of implementation. How do states opt out?

Constitutionality of health overhaul questioned: Legal scholars divided over Congress' authority (Washington Times, Oct. 28)

Washington lawyers David B. Rivkin Jr. and Lee A. Casey argued in an Aug. 22 column in The Washington Post that Congress has no constitutional power to tell people what they must buy.
"The Constitution assigns only limited, enumerated powers to Congress, and none, including the power to regulate interstate commerce or to impose taxes, would support a federal mandate requiring anyone who is otherwise without health insurance to buy it," they said.
But other legal scholars say that the Supreme Court has in recent decades taken a much broader view of Congress' commerce powers and would likely do the same in this case if the legislation's mandate is challenged in court.
"I would be willing to wager with Professor Barnett that the Supreme Court would uphold such a mandate, given the court's expansive reading of the Commerce Clause. In fact, I don't think the vote would be close," Washington and Lee University professor Timothy Stoltzfus Jost said.
Even some conservative legal analysts who oppose the health care reform think that in the end, if the legislation passes, Congress would win in the courts.

Health care pools: Let youth jump, or push them? [Push, push, push...] (NPR, Oct. 27)

The bill passed by the Senate Finance Committee would allow insurers to charge older adults four times the amount it charges younger people.
The House bill and the Senate health committee bill make a different choice: They would limit what insurers can charge older adults to two times the amount.
The insurance industry strongly prefers the higher 4-to-1 multiple.
Alissa Fox, senior vice president of the Blue Cross Blue Shield Association, says the fear is that if you make insurance too expensive for younger adults, they won't buy it.
"It's very important to have significant discounts for younger people so they purchase insurance," Fox says.
But the insurance industry is leaving out a critical element, says Linda Blumberg, a researcher at the Urban Institute. She says the current health overhaul bills all provide subsidies for lower income Americans, and "the young adults tend to be lower income, so they really are buffered a great deal from the full impact."

The rest

No fever may not mean no H1N1 flu (Minnesota Public Radio, Oct. 28)
End of COBRA subsidy rattles newly unemployed (Kaiser Health News, Oct. 28)
The lineup: Harry Reid's toughest votes (Politico, Oct. 28); Minnesota delegation weighs in on Reid's public option (Minnesota Public Radio, Oct. 27); Defections have Democrats casting about for Plan B (Politico, Oct. 28)
The influence game: Doctors' lobby in a tricky spot (AP, Oct. 28); A delicate dance for two health lobbyists (NY Times, Oct. 27)
Constitutionality of health overhaul questioned: Legal scholars divided over Congress' authority (Washington Times, Oct. 28)
Proposed long-term care insurance program raises questions: Opponents warn plan could require vast infusions of cash (Washington Post, Oct. 27)
A dubious alternative: There's no evidence that homeopathic products can prevent flu (Washington Post, Oct. 27)
New database to help set payouts by health insurers (NY Times, Oct. 27)
Anxious crowds meet ad hoc swine flu police (NY Times, Oct. 27)
Compromised care: Psychotropic drugs given to nursing home patients without cause (Chicago Tribune, Oct. 27)

Health Care Roundup, Oct. 27: Maybe It's a 'Female Thing'

2009-10-27T09:45:00.001-05:00

[Only thing to do is jump over the moon...]

The best

October 28 is National Comprehensive Sex Ed Call-In Day! (Feministing)

Call your reps and senators to let them know how you feel about comprehensive sex education! Don't forget--comprehensive sex ed includes abstinence education (that's why it's comprehensive!) as well as information about contraception, and multiple reputable sources show that comprehensive sex ed is more effective than abstinence-only sex ed (or no sex ed at all) in curbing teenage STIs and unwanted teenage pregnancy, which isn't going away any time soon. Let's real--your kids are having sex. Help them get the information they need in school--especially those kids whose parents aren't comfortable talking about sex.

Nervous to call in? If you worry about speaking on behalf of others, don't worry, you're not alone--7 out of 10 Minnesotans want children to learn about both abstinence and contraception in school.

Bill to increase access to contraception is dividing Filipinos (NY Times, Oct. 25)

Abortion is illegal in the Philippines. Birth control and related health services have long been available to those who can afford to pay for them through the private medical system, but 70 percent of the population is too poor and depends on heavily subsidized care. In 1991, prime responsibility for delivering public health services shifted from the central government to the local authorities, who have broad discretion over which services are dispensed.
Many communities responded by making birth control unavailable.
More recently, however, family planning advocates have been making headway in their campaign to change that. Legislation before the Philippine Congress, called the Reproductive Health and Population Development Act, would require governments down to the local level to provide free or low-cost reproductive health services, including condoms, birth control pills, tubal ligations and vasectomies. It would also mandate sex education in all schools, public and private, from fifth grade through high school.

***
But attempts to make reproductive services more broadly available have met resistance, leading to the defeat of several bills in Congress over the past decade.
The main opposition in this overwhelmingly Roman Catholic country has come from the church and affiliated lay organizations, which say the proposed law would legalize abortion. In churches across the country, signs have been posted that read: “Yes to Life! No to RH Bill!”
One organization, the Catholic Alumni United for Life, said in a position paper that the legislation would promote abortion by financing abortion-inducing drugs, and therefore “violates explicit Catholic teaching.”
The Rev. Melvin Castro of the Episcopal Commission on Family and Life, an arm of the Catholic Bishops Conference of the Philippines, said the Catholic Church and the laity would fight the bill, if passed into law, up to the Supreme Court.

Fight erupts over health insurance rates for businesses with more women (Kaiser Health News, Oct. 25)

The Pennsylvania home health care company Linda Bettinazzi runs is charged about $6,800 per worker for health insurance – $2,000 more than the national average for single coverage. One reason: nearly every one of her 175 employees is a woman. Insurers say women under the age of 55 cost more to cover because they use more health services, and not just for maternal and infant care. But Bettinazzi, the president and CEO of Visiting Nurse Association of Indiana County, believes there's something inherently wrong in charging her company more because it hires a lot of women. "There's a great sense of unfairness," Bettinazzi says. "I feel angry, and maybe betrayed would be a good word." Gender rating is the norm today, part of a complex formula of risk factors – including health history and age -- insurers say has been necessary to fairly price policies. But advocacy groups for women argue that charging more for women than men is discriminatory and should be illegal.

[The only way out is up, Elsie said.]

The other best

Accidents of history created US health care system (NPR, Oct. 22)

By the late 1920s, hospitals noticed most of their beds were going empty every night. They wanted to get people who weren't deathly ill to start coming in.
An official at Baylor University Hospital in Dallas noticed that Americans, on average, were spending more on cosmetics than on medical care. "We spend a dollar or so at a time for cosmetics and do not notice the high cost," he said. "The ribbon-counter clerk can pay 50 cents, 75 cents or $1 a month, yet it would take about 20 years to set aside [money for] a large hospital bill."
The Baylor hospital started looking for a way to get regular folks in Dallas to pay for health care the same way they paid for lipstick — a tiny bit each month. Hospital officials started small, offering a deal to a group of public school teachers in Dallas. They offered a plan for the teachers to pay 50 cents each month in exchange for Baylor picking up the tab on hospital visits.
When the Great Depression hit, almost every hospital in the country saw its patient load disappear. The Baylor idea became hugely popular. It eventually got a name: Blue Cross.
"When I actually started studying this stuff, I got interested because I wondered why we have an employer-based system," Thomasson says. "It comes right out of Blue Cross." The genius of that approach, she says, was marketing it to groups of workers.

The rest

Ailing planet seen as bad for human health: Advocates' report links climate change to worsening of diseases (Washington Post, Oct. 27)
Elective deliveries on the rise, but hospitals try to limit labor induced too soon (AP, Oct. 27)
Lawmakers, White House consider bipartisan route to bend health 'cost curve' (Kaiser Health News, Oct. 27)
AARP: Reform advocate and insurance salesman (Washington Post, Oct. 27)
In treatment, you may need an advocate: Patient advocates help to manage care (NY Times, Oct. 26)
Senate to include public option in health overhaul bill (NPR, Oct. 26); Public option push in Senate comes with escape hatch (NY Times, Oct. 26); Revived public option may freeze out Snowe [anyone else reeeeaaally tired of the Snowe puns?] (NPR, Oct. 27)
Debate over different swine flu vaccinations in Germany overshadows start of mass vaccinations (AP, Oct. 26)
A follow up to last week's altered cancer screening recommendations; especially helpful when addressing prostate cancer: Cancers can vanish without treatment, but how? (NY Times, Oct. 26)
Ohio struggles to find doctors willing to offer advice on best way to put inmates to death (AP, Oct. 26)

And the worst

Park Nicollet flu scheduling hotline overwhelmed (St. Paul Pioneer Press, Oct. 26); Park Nicollet shuts down flu appointment line (Minneapolis Star Tribune, Oct. 26)

The catch? You now have to e-mail to get an appointment. The other catch? If you don't have e-mail, you're apparently SOL.

So, in essence:

Dear Anyone Without E-mail,

Go f*** yourselves.

Love, Park Nicollet.

Health Care/Reform Roundup, Oct. 26: You Are What You Eat

2009-10-27T09:05:00.000-05:00

The best

Food label program to suspend operations: 'Smart Choices' food labeling loses support (NY Times, Oct. 23)

The Smart Choices logo began appearing on food packages this summer but immediately met with criticism from some nutritionists who felt its criteria were too lax. They pointed to sugary cereals, like Froot Loops, and fat-heavy products like mayonnaise, which they said should not be considered among the healthiest choices in the supermarket. The first ingredient in Froot Loops is sugar.
The F.D.A. sent the program a letter in August voicing concern that the label could lead consumers to choose highly processed foods over healthier foods, like fresh fruits and vegetables and whole grains.

ADDED: Tips for buying locally grown meat (Minneapolis Star Tribune, Oct. 26)

Farmers are sympathetic. "I don't argue with the customer. I know I'm expensive," said John Wemeier, who owns Bar 5 Meat & Poultry in Arlington, Minn. Wemeier, who sells at the St. Paul Farmers Market, tries to hook customers on the taste and suggests they try a small package of bacon, breakfast sausages or whole chicken.

For other customers, buying smaller packages of meat meshes well with goals to cut back on beef for health and environmental reasons. (The world's livestock alone accounts for 18 percent of all greenhouse gases, according to recent a U.N. study.)

When I compared prices on ground beef, chicken breasts and whole chickens among local, small farmers, the difference was usually less than 5 percent. Even though production costs can vary a great deal, the farmers seem to keep prices consistent.

Go see it! Hungry planet: What the world eats (Minneapolis Star Tribune, Oct. 23)

How much food does your family eat in a year? A fascinating new exhibit at the Bell Museum shows how dinner varies throughout the world in quantity, substance and cost. "Hungry Planet: What the World Eats" continues until May 9, 2010.

The exhibit focuses on 10 cultures, many with ties to Minnesota, and is based on the book "Hungry Planet," by Peter Menzel and Faith D'Aluisio. Their book won the James Beard Foundation's Book of the Year Award, which I wrote about. in a Taste cover story in 2006. For an interview with Peter and Faith, see this story.

Uganda food crisis undermining efforts to fight HIV/AIDS (The Guardian, Oct. 21)

The National Community of Women Living with HIV/Aids (NACWOLA) in Uganda, which promotes positive living for women with the virus, has warned that HIV-positive patients in eastern Uganda are abandoning their antiretroviral (ARV) treatment "in droves" because of a lack of food.
ARVs need to be taken with food, otherwise there could be severe side effects, such as dizziness and vomiting.
In an article written on the NACWOLA blog last month, the organisation said that unless more food becomes available there would be "drug resistance and death". It called on the government to do more to tackle the food shortages.

The rest

Editorial: Aging in place is not so easy (Kaiser Health News, Oct. 26)
Behind public option: Subsidies fight (Politico, Oct. 26)
A push for colleges to prioritize mental health (NPR, Oct. 26)
Politics aside, annual Medicare fix is same old story (NPR, Oct. 25)
Can 'bundled' payments help slash health costs? (Kaiser Health News, Oct. 25)
Health coverage 'plan' was no insurance at all (Minneapolis Star Tribune, Oct. 25)
But it should probably be noted that Massachusetts, although totally rocking on the coverage end, is also bleeding itself dry... Opinion: After reform passes (NY Times, Oct. 25)
Dance music puts the groove in exercise (Minneapolis Star Tribune, Oct. 25)
Further strengthening the argument that mandates and exchanges will be useless without a public option: How an insurance mandate could leave many worse off (NY Times, Oct. 24)
Obama declares swine flu a national emergency (NY Times, Oct. 24)
For the employed but uninsured, going without health coverage is work (Kansas City Star, Oct. 24)
Backlash, new polls get public option back in health care debate (Minneapolis Star Tribune, Oct. 24)
Worst case: Choosing who survives in a flu epidemic (NY Times, Oct. 24)
Opinion: Chronic illness and health care reform: I'm too tired to fight for this by myself (Women's Media Center, Oct. 23)
Health care reform plans neglect wellness and prevention (The Tennessean, Oct. 23)
I'm still pretty sure hand-washing messages would succeed if they incorporated Queen and headbanging. J said last week that he could coordinate the music in his head to rock through the scrubbing, peak as he was walking back to his cube, and start the piano slow rock just as he was sitting down. Good man. Searching for the right hand scrubbing message (NPR, Oct. 23)
Offer to let states opt out of health plan gains support (Wall Street Journal, Oct. 23)
Will health care reforms kick in on time for Americans? (CBSNews.com, Oct. 22); Dems push for benefits to start by 2010 (Politico, Oct. 25)
Ambulance companies start charging extra to transport extremely overweight patients (AP, Oct. 22)
New survey shows 1 in 5 kids had flu-like illness this month, most of it probably swine flu (AP, Oct. 22)
Battling addiction with those who know it best (NY Times, Oct. 22)
The effects of reimbursement on medical decision-making: Do physicians alter treatment in response to a managed care incentive? (Robert Wood Johnson Foundation, Oct. 2009)

And the druggy

Mankato set to collect old pills and medications (Minnesota Public Radio, Oct. 26)

If you've never thought about how to dispose of old or expired medications, think again. A friend of mine from college is working on her PharmD, and posted the following instructions to her MySpace blog a few years ago. Totally helpful:

This Week's Topic: Smart Disposal: A Prescription for a Healthy Planet

What do you do with your unused prescription meds? Do you flush them down the toilet or sink? Have you ever thought about the consequences of these drugs entering our sewer systems and making their way to our lakes and streams?

Researchers have found concentrations of both human and veterinary drugs in the waterways. Researchers have found antibiotics, natural and synthetic hormones, detergent metabolites, plasticizers, insecticides, and fire retardents in waters downstream from both urban areas and animal farmlands. One or more of these chemicals were found in 80% of the streams sampled by the US Geological Survey. 50% had 7 or more chemicals in them, and 30% had over 10 chemicals in them.

So, you want to dispose of some meds? The number 1 rule is....

DON'T FLUSH!

Most of these substances find their way into waterways through our sewer systems and septic tanks.

STEPS TO TAKE TO RESPONSIBLY DISPOSE OF MEDS

Check for state or local medication collection or take back programs
Check with hazardous waste facilities for disposal programs
If these options are not available, dispose of medications properly in the trash. Do not flush unless the medication label specifically states to do so.

WHAT YOU'LL NEED TO DISPOSE OF YOUR OWN MEDS

Cat litter or coffee grounds
Sealable plastic bag
Hammer and/or water

BEFORE YOU TOSS INTO THE TRASH

Crush unused solid meds and dissolve liquid meds.
Mix the meds with cat litter, coffee grounds , or other solid waste.
Place the meds in a plastic bag and seal it to avoid the risk of poisoning children or pets.
Remove all identifying personal info from the medication container.
Place the bag and the drug container in the garbage can.

REMEMBER

Besides protecting the environment and water supply, proper disposal of meds will prevent them from being diverted and used illegally.

ALSO OF NOTE

*Medications lose their efficacy once they expire. Some become 90% less effective after their expiration date. Moral of the story...don't hang onto expired meds, they probably won't help you anyway...and some can even degrade into something toxic!
*If you are given an antibiotic prescription for a certain amount of days (10 days is typically the norm), but you start feeling better on the 3rd day, finish the prescription!! You still have some bad bacteria living in you, and that stuff is more powerful than the good stuff you helped bring back. If you fail to finish the meds, you run the risk of bringing the infection back.

Odds and Ends

2009-10-26T08:28:00.003-05:00

This weekend's food haul: Leftover lasagna, hamburgers, sushi, baguettes with liverwurst, our favorite pasta and sauce (with pork, veal [leftover from leftover lasagna], and tofu this time... interesting), wayyyyyy too much Lambrusco, lemon cookies, apple dumplings, scrambled eggs with smoked Gouda, more liverwurst on toast, and more pasta and sauce. Man, we live a good life.

I really want to make homemade goodies for Halloween this year. Little, mini-chocolate bowls with mini-M&Ms sound super fun. And then I think: Who in their right mind would let their kid eat homemade Halloween goodies? But what if I wrapped them carefully, put tags on the goodies explaining exactly what they were, made the kids bring them directly back to their parents for permission, and still gave the kids a pre-packaged alternative (like Skittles or the like)? Then would it be alright? Sigh, methinks still no. Ugh. I wouldn't trust anyone else's salmonella-filled kitchen, either, I guess. But still. BOOOOOO.

Life Tastes Good

2009-10-24T15:55:00.003-05:00

J and I visited Saji-Ya today to celebrate having jobs, marriage, and not killing each other in the process of actually getting married, and I had my first raw sea scallop. And now I don't want to eat anything else, because I want to preserve the taste and texture in my mouth for the rest of the week, if I can.

I'm not sure that will work, though. I came home from the grocery store today with some great liverwurst, my favorite sausage, and some arugula and prosciutto for some nice baguette sandwiches tomorrow. (Meat, meat, meat! When was I ever a vegetarian?! We really are meat-free for nearly half the week...) And tonight we're making our favorite pasta sauce. I feel like I've pretty much reached the height of my life. And the fact that I get to share it all with J makes it that much better.

(I did make J try a piece of my scallop so he could at least know what I was talking about when I jabbered on for the rest of the day about it.) Oh, that sweet, slippery, chewy heaven...

Health Care Roundup, Oct. 22: Choices, Choices

2009-10-22T13:33:00.000-05:00

The best:

Framing health care debate as battle of sexes (NPR, Oct. 22)

Not only are women charged higher premiums for individual coverage during their child-bearing years, but they also are typically required to purchase expensive riders for maternity coverage.
And there is a body of evidence that shows women have been denied coverage by insurance companies citing "pre-existing conditions" that range from having previously given birth by cesarean section to having been a victim of domestic abuse.
At the recent Senate hearing, led by Democratic Sen. Barbara Mikulski of Maryland, Peggy Robertson, a Colorado mother of two, testified that she was rejected by an insurance company that determined her previous cesarean constituted a pre-existing condition. Delivering a baby by surgical procedure increases a woman's chances of needing it again in future pregnancies.
The Golden Rule Insurance Co. told Robertson, 39, that if she had been sterilized, the coverage would have been hers.

Blog: Rape victim's choice: Risk AIDS or health insurance (Huffington Post, Oct. 21)

Turner, 45, who used to be a health insurance underwriter herself, said the insurance companies examined her health records. Even after she explained the assault, the insurers would not sell her a policy because the HIV medication raised too many health questions. They told her they might reconsider in three or more years if she could prove that she was still AIDS-free.

Contributed by reader Toby: He's in the army now: Wife's cancer prompts man to enlist (Milwaukee Journal Sentinel, Oct. 18)

The Caudles are not fond of politics. Michelle and Bill have paid little attention to the shouting this summer over health care reform. They have not gone to any of the town hall meetings. They are well aware that politicians and interest groups would like to trumpet their story or dismiss it to score points in the debate - and they would just as soon avoid all of that.

"We're not activists," Michelle said.

But this year the national story of lost jobs became their story. And the saga of families losing health insurance was about to become theirs, too.

Except that Bill wouldn't let it.

True, he had been interested in the Army for years. And he could always request an emergency leave to come home if Michelle's condition grew dire (Army regulations allow this if a family member's death is imminent).

But for weeks before enlisting, Bill had sought other options. He revised his résumé. He answered "help wanted" ads, then watched the companies cut workers instead of hiring them. He interviewed for one job that would have paid $13 an hour - less than half of what he was making at PolyOne. He didn't get the job.

Finally, on May 13, his 39th birthday, he signed the Army papers.

The rest:

Attacking Dartmouth Atlas is off-target (Kaiser Health News, Oct. 22)
Study finds H1N1 virus lives longer than expected (NPR, Oct. 22)
DC students say schools' sex education is antiquated: Survey finds teens don't like talking to nurses, reject condom brand (Washington Post, Oct. 22)
The influence game: Firms resist new health rules (AP, Oct. 21)
Baucus: Doctors, patients, and the need for health care reform (NEJM, Oct. 21)
Pawlenty proposes state insurance pact (AP, Oct. 21)
Blog: Massachusetts docs ♥ universal coverage (NPR, Oct. 21)
A few cookies a day to keep the pounds away? (NY Times, Oct. 21)
Fact Sheet: Bubbling over: Soda consumption and its link to obesity in California (UCLA Center for Health Policy and Research, Sept. 2009)

The miscellaneous:

Help Fooducate test their food comparison tool!

It's a pretty neat tool that allows you to select something pre-packaged that you might eat (like Dinty Moore, Gatorade, or Doritos) and find a healthier alternative to that item. Sadly, they don't have Boo Berry in the comparison tool yet. But I'm pretty sure Boo Berry is a good alternative to potato chips. I think.

And the horrifying

Man's sudden food allergy was a medical mystery for months (Washington Post, Oct. 20)

No red meat? WHAT?! The horror... the horror... *rocking back and forth*

One ultrarunning problem, solved for good (NY Times, Oct. 21)

*URP* I just threw up a little. Not sure I needed photos for this article...