5 facts about the anti-reform mobs

1. These disruptions are being funded and organized by out-of-district special-interest groups and insurance companies who fear that health insurance reform could help Americans, but hurt their bottom line. A group run by the same folks who made the "Swiftboat" ads against John Kerry is compiling a list of congressional events in August to disrupt. An insurance company coalition has stationed employees in 30 states to track where local lawmakers hold town-hall meetings.

2. People are scared because they are being fed frightening lies. These crowds are being riled up by anti-reform lies being spread by industry front groups that invent smears to tarnish the President's plan and scare voters. But as the President has repeatedly said, health insurance reform will create more health care choices for the American people, not reduce them. If you like your insurance or your doctor, you can keep them, and there is no "government takeover" in any part of any plan supported by the President or Congress.

3. Their actions are getting more extreme. Texas protesters brought signs displaying a tombstone for Rep. Lloyd Doggett and using the "SS" symbol to compare President Obama's policies to Nazism. Maryland Rep. Frank Kratovil was hanged in effigy outside his district office. Rep. Tim Bishop of New York had to be escorted to his car by police after an angry few disrupted his town hall meeting -- and more examples like this come in every day. And they have gone beyond just trying to derail the President's health insurance reform plans, they are trying to "break" the President himself and ruin his Presidency.

4. Their goal is to disrupt and shut down legitimate conversation. Protesters have routinely shouted down representatives trying to engage in constructive dialogue with voters, and done everything they can to intimidate and silence regular people who just want more information. One attack group has even published a manual instructing protesters to "stand up and shout" and try to "rattle" lawmakers to prevent them from talking peacefully with their constituents.

5. Republican leadership is irresponsibly cheering on the thuggish crowds. Republican House Minority Leader John Boehner issued a statement applauding and promoting a video of the disruptions and looking forward to "a long, hot August for Democrats in Congress."

New Wearable Feedbag Reduces Eating Effort

New Wearable Feedbags Let Americans Eat More, Move Less

We Use Much More Than 10% of Our Brains

Quote of the day:
"There are some people who would never have fallen in love if they had not heard that there was such a thing."
--Francois VI, duke de la Rouchefoucauld (1655)

Happy New Year!

The new year is a good time to get straight on some deeply-embedded misunderstandings.

We believe many things about health and medicine that are questionable at best, and sometimes downright wrong. The “British Medical Journal” recently published a list of seven things we believe that just ain’t so. It was compiled by Rachel C. Vreeman of the Indiana University School of Medicine an Aaron E. Carroll of the Regenstrief Institute.

1. “You should drink at least eight glasses of water a day.” This advice has been around since 1945, but there’s no scientific evidence to support it. In fact, excessive water drinking can be fatal.

2. “We use only 10 percent of our brains.” Modern medical imaging shows that there’s no region of the brain that is completely inactive.

3. “Hair and fingernails continue to grow after death.” They don’t, but dehydration of the body and retracting skin can make it appear so.

4. “Reading in dim light ruins your eyesight.” It can strain the eyes and reduce blinking (which may cause uncomfortable dryness), but the effects are temporary. There’s no permanent effect on eye function or structure.

5. “Shaving causes hair to grow back faster or coarser.” Numerous studies have shown this to be false. Shaving does remove the finer, tapered ends of hair, which can make the remaining stubble seem coarser. And new hair emerging from the skin can appear darker because it has not been lightened by sun or chemical exposure. But shaving itself doesn’t affect the hair at all.

6. “Mobile phones are dangerous in hospitals.” There’s little real evidence to support the idea that cell phones can interfere with critical medical equipment. All of the evidence cited is anecdotal and pretty dubious.

7. “Eating turkey makes people especially drowsy.” Tryptophan, an amino acid, is involved in sleep and a form of it is marketed as a sleep aid. Turkey contains tryptophan, but so too does chicken and beef. Pork and cheese contain more tryptophan than turkey. Sleepiness after a big turkey meal is more likely due to diverted blood and oxygen flow from the brain to the digesting stomach.

The complete article can be read here.

View From Nepal

Quote of the day:
“Someday I want to be rich. Some people get so rich they lose all respect for humanity. That’s how rich I want to be.”
--Rita Rudner

Today, a first-hand look at life in a hospital in Tansen, Nepal. Two of our friends--a social worker and a physician--are leading a work team there:

“Our experiences here can only be described as intense and vivid. Our white faces are becoming known around the hospital and the staff smile and offer directions.

“Today the toy rounds people gave out small beach balls with globes of the world on them. The families are often here at bedside and they were so pleased. In fact, the balls have become quite precious.

“We used the balls not only as toys but also as part of our introductions when we gave our in-services. We marked the balls with an X on San Diego and another on the area of Tansen, Nepal.

“They were so happy to have a globe of the world! Several of the Nepalese who are auxiillary staff have a friend in the U.S. They each wanted to look up the state where they know someone.

“The chief of social services explained to me that he knew about California--it is right next to Florida. This is not surprising as a lot of folks in the U.S. have only a foggy notion of how to locate Nepal.

“Yesterday was the hand-off of the carpentry and maintenance tools to the staff there. The guys couldn't wait to get their hands on the new tools; they were so excited.

“The workmen are amazingly talented and everything we have seen thus far is pretty much done by hand. They even cut steel rebar with a score mark, a rock placed under the bar, and a sledge hammer. It is a slow process.

“During the last two days we have painted 5 labor bays in the maternity ward. The sanitation is nonexistent but at least the surroundings look more clean (we used a cream color).

“Today we worked in the busy cashier area and we were the best show in town. It was amazing how many people watched. Some of the guys wanted to know how we put the rollers together and the blue tape to keep a line between colors was a great novelty.

“I gave my in-service today on stress to social service-chaplaincy-outreach workers. Their biggest concerns were suicide attempts, alcoholism (among staff), and patients being dumped off at the gate with no money, no family, and no contacts.

“Social service staffers are expected to give the emotional support and do discharge planning with no resources to work with. Sure sounds familiar!

“Today we had an afternoon foray into town and saw the main square that the Maoists destroyed a year ago Jan. The historical 'palace' was a police station and is now a huge pile of rubble. It is being cleaned up by hand and the plan is to rebuild it in the historical mode as it was before. Estimated time of construction is 3 years.

“Tomorrow we will hit the painting hard in the a.m. and take the afternoon off to have a mini-trek to the home of the Guest House Manager where his parents live. He promises to introduce us to the buffalo who is providing our milk.

“I miss hot water and functional showers.”

The Best Part of Going to the Hospital

Quote of the day:
“I find it amazing that in this day and age, American women seem to resent smart American women in high positions.”
--Mohan Ram

A very long (5 hour) test for Merrie today, to check blood flow in and around her heart. And then a wait for results to see if she could be discharged.

At 6:30 she was very pleased to hear that she was being released. At 9:00 it actually happened. Then we waited a half hour for a prescription.

See what I mean? Waiting. It’s one of the prices we pay for our health-care system.

But the best part of being in the hospital is going home.

Good Summer Viewing

Quote of the day:
“Who are we?”
--Michael Moore, in Sicko

Quote of the day no. 2:
“First, we must learn to count to one.”  
--Martin Luther King

See Sicko. It’s worth your time.

I know what you’re thinking. “In the middle of summer, why would I want to go to a film about health-care policy? Boooorrring.”

The thing is, it’s not boring. In fact it’s probably more interesting and entertaining than the other films at your multiplex.

Yes, Michael Moore can be hard to take. But there’s little of him in this film. None of the ambush and embarrass scenes as in his previous films. I don’t like that technique. I think it’s petty and almost childish (“I’m gonna tell my mom!”)

If you think Moore is a flaming liberal, I’m sure you won’t see the film. That’s too bad, because it’s about all of us.

The film is a series of personal stories from people who might be your neighbors or siblings or friends. Just normal people trying to go to the doctor to get some help. We all know someone who could share a similar story.

These stories are set against those of other normal, everyday people in other nations who also have needed to go to the doctor.

The movie is sometimes funny, sometimes tragic, sometimes poignant--but always entertaining and interesting. It is Michael Moore’s best film.

I encourage you to put your preconceptions aside and simply go see it.

CNN vs. Michael Moore

Quote of the day:
“Whenever it is universally known that power is the creation of its victims, the world trembles.”
--Earl Shorris

When I turned on CNN this morning, my eyebrows were almost burned off by Michael Moore.

They were replaying a bit of Wolf Blitzer’s Situation Room from the day before. They had scheduled an interview with Michael Moore and introduced it with a piece by their medical reporter, Dr. Sanjay Gupta.

Gupta had called into question a statistic or two from Moore’s movie Sicko. He also said he liked the film. The discrepancies Gupta were pointing out were small, but he said Moore had “fudged” some numbers.

That’s what lit Moore’s fuse. What ensued was both entertaining and quite constructive.

The other criticism was that Moore did not report any of the problems or the costs of the French, Canadian and British systems, all of which he praised. His response to this was that, in his memory, there had been nothing but criticism of these systems in the American press for the last ten years or longer.

I think Moore makes an excellent point there. Of course there are problems with the French, Canadian and British systems. Can you remember seeing anything positive about them in the press? I can’t.

The salient point for the average American is that, in these countries, health care is free and accessible to all. That’s what Moore portrays. As citizens of each of these nations talk about what it’s like going to the doctor, they actually seem calm and satisfied. Can you imagine?

We are so conditioned to working our own system, it’s hard for us to imagine not having to do that anymore.

The most-important thing to come out of the Michael Moore-CNN fracas is not about health care. It’s about the role of the media.

Moore took Wolf Blitzer and CNN to task for failing to be more aggressive in reporting about Iraq as well as health care. He also was still mad about their criticism of his previous film Fahrenheit 911. He said, correctly, that the facts he presented in that film have not been disputed, and that his conclusions have turned out to be true. And he asked for an apology, which didn’t come.

Moore is right to criticize. News organizations such as CNN have become accustomed to simply repeating facts that are shoved their way by self-interested organizations, including the U.S. government and think tanks sponsored by the health-insurance industry.

They no longer are able or willing to investigate or even question, and certainly not with any depth. So it is left to Michael Moore, with all his obnoxious self-righteousness, to present something other than the “company line.”

Seeing Inside Myself

Quote of the day:
“You know what they say about fear. The only cure is to cut off your head.”
--Ronald Bass and Michael Hertzberg, from the movie Entrapment.

As part of some routine medical tests, today I had an echo-cardiogram. It’s similar to a sonogram in producing images of what is happening inside your body.

It’s hard to describe the feeling of watching my heart beating. More precisely, watching all the individual movements of my heart as it beat.

I could see one side of the heart pump, then the other. I could see the valves opening and closing. It was simultaneously eerie and wonderful.

I lay there thinking that my heart does all these things continuously, and has for many years. It was hard for me to focus on just the physiology of what was happening. A very gentle sense of awe settled on me.

When we were finished I shook the technician’s hand and headed to the parking lot.

It was a quiet pre-holiday evening at the hospital. I passed just one person in the hallway. It was a nurse coming on duty. I started to say hi but she was distracted.

It was a glorious evening outside.

Reason in the Health Care Debate

Quote of the day:
“Life in Lubbock, Texas taught me two things: One is that God loves you and you’re going to burn in hell. The other is that sex is the most awful, filthy thing on earth and you should save it for someone you love.”
--Butch Hancock

The health-insurance debate is back, thanks to the Democratic presidential candidates and Michael Moore’s movie Sicko, which is opening in a week. See the February 1 post How We Ration Doctor Visits.

Just like every issue debated and shouted about in the press, we hear a disproportionate amount from two extremes. It’s either
“LOOK OUT! SOCIALISM, RATIONING, AND LONG LINES ARE COMING!!!”
or
“PHARMACEUTICAL COMPANIES, HEALTH INSURERS, HOSPITAL COMPANIES, AND DOCTORS ARE ALL CORRUPT AND FAT!!!”

Let’s be reasonable, shall we? Is it possible for us to gradually acknowledge a few things? For example, that there is much good about our health-care system? And that there are way too many people who can’t get reasonable access to it?

We also need to recognize that, as businesses, the drug manufacturers, health insurers and for-profit hospitals have priorities that may not be in line with all of our goals as a nation. Any business, big or small, is always seeking primarily to lower costs and raise prices. It’s the nature of free enterprise.

If our goal is to make health care more-accessible for those who can’t afford it, it will increase costs. This goes directly against the highest priority of our health providers. This means that the government has to be involved, as it is with Medicare.

This does not mean that we are headed toward “socialized medicine.” It also does not necessarily mean that the system will be wildly inefficient.

But, if our goal is to provide health care access to those who need it but can’t afford it, we will need to deal with change and occasional inefficiency.

Fat Warrior

Quote of the day:
“Don’t be angry with the rain; it simply does not know how to fall upward.”
--Vladimir Nabokov

I am a fat warrior. Not a warrior who is fat, but a warrior against fat. Eating fat.

If you get annoyed when someone is constantly pointing out how much fat is in everything you’re eating, you do not want to be around me this week. This started when both my doctor and Merrie’s recommended that we take a nutrition class to lower our blood cholesterol.

There has been so much information in the press for so many years, I thought I knew most everything about saturated, unsaturated and polyunsaturated fat, cholesterol, and what foods to avoid. I was wrong.

Just like a financial planner will ask you to write down everything you spend in a week, our instructor has assigned us to write down everything we eat each day this week. Then we add the fat grams of all the items to see if we’re where we should be according to our risk factors for heart disease. My daily fat intake is supposed to be between 45 and 60 grams.

I thought I knew which foods had fat and which didn’t. But what I didn’t know was how wide a variation there is in fat levels. Did you know that a flour tortilla has 4 grams of fat, while a corn tortilla has 1? How about this: a croissant has 18 grams of fat, a slice of bread has 1. An 8 oz. glass of whole milk has 10 grams, 1% milk has 2, nonfat milk has zero.

If you’re not annoyed enough yet, try this: a bag of microwave popcorn has 32 grams of fat, air-popped popcorn has zero. For eating out, a caesar salad has 40 grams while a chicken fajita pita has 8. And a taco salad with tortilla shell has 55 grams of fat, a teriyaki bowl has 3.

As I said, I’m a food warrior. A somewhat insufferable, self-righteous food warrior. But don’t worry. I’ll get over it soon, and I hope to have better eating habits.

I’ll close with this favorite quote, which comes from Woody Allen’s movie Interiors: “You can live forever if you give up everything that makes you want to.”

The Diet Shock

Quote of the day:
"Every so often, we pass laws repealing human nature."
--Howard Lindsay

Quote of the day no. 2:
“If a nation expects to be ignorant and free...it expects what never was and never will be.”
--Thomas Jefferson

Expression of the day:
“Finger-spazzing.” As in “finger-spazzing” a Blackberry.

Maybe it’s just the programs I watch, but it seems that there are quite a few commercials around that feature extreme close-ups of things like bacon cheeseburgers, fried chicken and juicy ribs. I used to indulge the Pavlovian response--I’d salivate and get hungry. Now I find myself thinking how much fat, salt and refined carbohydrates are in everything.

For many years, we have heard warnings about eating foods high in fat and refined carbohydrates. Because of what Merrie has been through, heeding these warnings is no longer optional for us.

It shouldn’t be news to any mildly tuned-in person that we need to keep our consumption of these things as low as possible. Yet, inevitably when restaurants or ready-to-eat food are advertised, what we see is the juicy, high-fat bacon cheeseburger, french fries and dripping sundae.

This is not the fault of the restaurants. They are providing what people want. Several years ago, there were actually more healthy choices on restaurant menus. But they didn’t sell. It didn’t make business sense to keep healthful items on their menus, so they were dropped.

Due to our increasing weight, there will need to be more pallbearers at our funerals, which will occur much sooner than we expect. At the rate we’re going.

If You Have Your Health....

Question of the day:
When was the last time you used duct tape on a duct?

Quote of the day:
"The best way to have a good idea is to have a lot of ideas."
--Linus Pauling

Man, there were a lot of people at the pharmacy this afternoon! I’ve never seen it that crowded.

As I was leaving the parking lot, I saw this on a banner on the building across the street: “If you have your health, you have it all.” That’s gotta be one of the world’s biggest cliches (right up there with “first and foremost”).

But it’s true, isn’t it?

This evening, Sophie had a barking fit in the backyard and came in smelling like skunk. Oh, joy.

Fortunately, it wasn’t a full-on skunk spray, but rather more of an essence. Sort of like when you spray the cologne and walk through the mist. Or spray the cologne on the ground and roll in it.

Merrie sprang into action (great to see!) and took the dog into the garage for a washing and drying. And that took care of the problem.

Our quiet and restorative days continue.

How to Get Better

We’ve received many terrific and cards, notes, photos and e-mails over the last few weeks. Thank you for your generous support and thoughtfulness!

Our most-recent get-well wish is a wonderful and insightful book called How to Get Better, put together by Cheryl’s kindergarten class, room 9. I wish I had space to show all the pages--maybe in future entries.

Here’s the advice, and who it’s from:
Amilia: “Don’t eat lots of candy.”
Alexa: “Go to the doctor.”
Tomas: “Blow your nose.”
Heath: “Take the right pills.”
Bianca: “Sleep when they tell you.”
Ivy: “Sneak into your parents’ bed.”
Michael: “Go to the hospital.”
Evan: “Hide toys in bed.”
Rachael: “You must take your medicine.”
Trinh: “Stay in bed.”
Erick: “Get lots of flowers.”
Andy: “Tell the bad germs to go away.”
Levon: “Get a good pillow.”
Preston: “Ask for things like toys.”
Deandra: “Watch a lot of TV.”
Jamilah: “Sneak around at night.”
Long: “Sleep with stuffed animals.”
Adrian: “Wear your slippers.”
Ethan: “Wear your Superman pajamas.”

This is all good advice! Thank you so much for sending it along.

Sergio Leone at Kaiser Hospital

It seems appropriate to touch on this topic since we’ve been enmeshed in the health-care system since Valentine’s Day:

Follow-up to my earlier entries Health Insurance and Iraq and How We Ration Doctor Visits:
“A majority of Americans say the federal government should guarantee health insurance to everyone, especially children, and are willing to pay higher taxes to do it, according to the latest New York Times/CBS News Poll.”
--The New York Times, today.

True truism of the week:
“Life is what happens when you’re making other plans.”

Merrie continues to do well. We are both well settled into her new room--the sixth since she arrived. She ate all her lunch and it tasted good to her. She’d worked up an appetite by taking two laps around the nurses’ station with a walker this morning. She walked again in the afternoon and once again in the evening. Those who know Merrie know there is a bigger risk of her attempting too much than too little. But with the help of the nurses she’s doing a great job of pacing herself.

There’s a small cha-cha (remember: two steps forward, one step back) in that she has developed a low-grade infection which the doctors are trying to identify and treat. Because of this, we will be leaving the hospital no earlier than Monday. While we know this is the best course, we had hoped for earlier.

The afternoon brought a refreshing, long nap for her, and a short one for me. Sleeping is sometimes interrupted by the phone at the nurses’ station, which has a ring like a fast version of the first few bars of The Good, The Bad and the Ugly.

Sleep, good food and a walk are all mighty wonderful things.

How We Ration Doctor Visits

Quote of the day:
“Television news is like a lightning flash. It makes a loud noise, lights up everything around it, leaves everything else in darkness and then is suddenly gone.”
--Hodding Carter

India statistic of the day:
Expected population in 2050: 1.6 billion (surpassing China).
--Edward Luce, from "In Spite of the Gods: The Rise of Modern India."

More on Health Insurance and Iraq:
“By not taxing employer-paid insurance, the government now provides a huge invisible subsidy to workers. [Bush’s proposal] would not end the subsidy, but by modifying it with specific deductions for insurance, he would force most workers to see the costs.”
--Robert J Samuelson, in the January 29th Newsweek.

Samuelson makes an important point. Most of us who have health insurance may know only what our premiums are, what our copayments are, and what the limits of our coverage are. We don’t know the real cost of the care we receive.

The health care debate is all about costs. It’s all about money. For years, proposals for any kind of government-sponsored health care were derided as systems for “rationing” doctor visits. Critics pointed to inefficiencies and problems in systems such as Canada’s, suggesting that the last thing we needed was “rationing.”

Another Newsweek columnist, Anna Quindlen, made an excellent observation about this a few years ago. She pointed out that we already “ration” health care, but the rationing is invisible because it is based on money. Those who have money get health care, those who don’t do not, or are enormously inconvenienced.

To make good decisions about how to provide healthcare coverage to those who most need it, it is vital that we understand what the costs are. Then we can decide the best way to pay these costs.

Doxology, Health Care and Taxes

Quote of the day:
“Praise God from whom all blessings flow, burst the choir, and the money was carried away in a wicker basket never to be seen again.”
--William Gaddis

Architecture quote of the day:
“We are going to grow to over 30,000 students, and we are going to have to take down some of these interim fixes.”
--University of California Irvine campus architect Rebekah Gladson. She was referring to the school tearing down two buildings to make room for a six-story, 180,000 square-foot engineering building. One of the razed buildings was designed by Frank Gehry, the other by Rebecca Binder.

Follow-up to Health Insurance and Iraq:
“The [Bush] tax proposal would have the effect of driving people to the small-group insurance market--a market that has proved unstable. For many people, even with a tax break, coverage would remain unaffordable.”
--Richard Umbdenstock, president of the American Hospotal Association.

According to a poll by the Public Policy Institute of California, 63% of the state’s population favors a guarantee of health-care coverage, even if it means raising taxes.

Simultaneous with President Bush’s proposal is one by California Governor Arnold Schwartzenegger which does provide health coverage for most of the population without it.

Iraq and Health Insurance

Quote of the day:
“There will be an answer, let it be.”
--Paul McCartney

There has been a lot of talk about the relevance or irrelevance of Tuesday’s State of the Union address. I think there’s a lot of room for discussion and negotiation on each item that President Bush proposed.

Two of his underlying assumptions baffle me. First, I thought that our biggest problem related to health insurance is the huge number of people who cannot afford it. How exactly is making premiums tax-deductible going to make health insurance affordable for people who don’t have it, most of whom are in a tax bracket between 0% and 15%?

If a monthly premium of $500 is not affordable, is 15% less ($425) going to be affordable for a family that is already living paycheck to paycheck? I’m not saying that the tax deduction would not help a few people, and it certainly would be a nice present to those in higher tax brackets. But it seems to me there is a much, much bigger problem that needs attention: providing health insurance for those who most need it and cannot afford it.

The second assumption relates to the possibility of our withdrawal from Iraq. Bush made the obvious point that there would be chaos of we removed our armed forces. Won’t there be chaos whenever we decide to withdraw--whether it be now, in two years or in five years? Former National Security Advisor Richard Clarke said this several months ago--see Iraq Logic.

Watching the chaos and bloodshed that follows our withdrawal will be very difficult. But using the potential for chaos as a reason for not withdrawing from Iraq now is a very weak argument.

Panic First, Then Panic

“There will be horrific financial implications. More money will be needed for providing health care benefits that could otherwise be used for fighting fires or keeping libraries open.”

That is an expert quoted near the lead of an AP news story yesterday. The story was about the growing cost of public employee health benefits.

The very end of the same story has this quote from a different expert: “This isn’t Chicken Little. It’s wrong to panic, and it’s wrong to put your head in the sand and ignore the liability altogether. The middle ground of responsible funding is the way to go.”

Underfunded pension and health-benefit liabilities is a very, very serious issue for the long-term financial health of our governments at every level. But what is the best way to approach this problem?

To me, the first quote seeks to incite fear. Is that constructive, considering our judgment is impaired in the presence of fear? We can’t make good decisions when we feel fear. Especially decisions that will affect us for the next 50 to 100 years.

Which is more productive: to set about rationally assessing the scope of the problem so that we can begin to form a responsible solution, or running around in a panic that fire stations and libraries will have to close?