Insurance: Solving America's Health Care Mess

What is the solution to insurance? Right now, Maryland is forcing Wal-Mart to offer insurance to it's people or else they will be taxed to make up the Medicaid costs. I'm listening to Rush right now and he's apoplectic. With good reason, I think.

I am not against poor people. When it comes to insurance, I am poor people. We have a high deductible plan $5,500.00/year before one penny of insurance is invoked. Every year we have sidled right up to the $5,000 mark. Every disease-ridden year. Oy.

At our office, we do not accept Medicare/Medicaid. If a patient with that coverage wants us to treat them (because we're the best Alternative Health Care Providers in Houston, of course), they must sign a waiver. They must pay...in cash.

Why don't we provide for the government? Because he is an odious taskmaster, that's why. It is impossible to please him. He pays terrible. We can do nothing right. And when we are wrong, we don't just pay them or people back, we go to Federal Mandated-sentences Jail. Am I being alarmist? Probably. Our office is small potatoes compared to other practices out there, but we must comply to all the crazy rules, too. The regulations stiffle patient care and if you really care about the patient you give lots of services away for free. And why not? This is America--HOME OF THE FREE.

The government is bad enough. The Insurance Companies, the government dressed up in ruffled skirts and stilettos, is equally as bad. Cutting fees like a deranged seamstress, rejecting pleas for payment with callous disregard, limiting patient treatment like sadistic bureaucrats they are all adds up to lots of pain and little gain. Little health gain. Little wealth gain. And the two are connected.

The solution? Go after companies and MAKE them pay their employees health coverage! Yeah, that's the ticket!

Hey, wait a minute. I am an employer, too. Barely able to cover my own health care expenses, we would have to get rid of our two part-time employees if we were forced to pay their insurance coverage, too. It's just to much.

The problem, as always, is the government. Insurance companies now follow Medicaid's lead when it comes to coverage. The government covers the barest minimum for health care survival. So insurance companies have followed their lead. Interestingly, though, fees for one thing are excessive, things for others are obscenely low. Some specialties thrive. Some are dying. General practitioners in stand-alone practices are dying breeds.

What is happening is this: Doctors and patients are turning back to an old standard: CASH. You see, when a patient pays cash, he seems to miraculously get better faster. You might think that it's the doctors sucking up all the coverage and in some cases that is true. But for doctors like us who want our patients to get healthy ASAP, we find that our cash patients consistently follow care recommendations more closely, respond to treatment quicker and generally take charge of life more. They have a BIG incentive to do so--their own pocketbook. While the insurance patients tend to look at their insurance plans as banks from which you can indefinitely withdraw. SOMEONE is paying those bills people. You want taxes to go down? You want your pay at work to go up? Lower your health care usage. Most of it's crap anyway.

Here is what we did for our son because of our lack of health care coverage. Some of you might think that it proves we need universal coverage, but I don't think so. When Little Toot burned his hand, it was an obvious emergency. We knew that we had a $500 payment minimum for what would probably be a one-hour hospital stay, but we had to do it. So we did. At the hospital, the doctor showed us how to treat the burn. We watched closely. He gave us explicit directions for care. We listened attentively. When we got home. We did exactly as told.

Now, the doctor wanted us to follow up with a Hand Surgeon the next day. That would have been at least another $200. For what? So she could look at the hand and tell us what we knew: that the hand was healing nicely and quicker than expected considering the severity of the burns. She would have then asked us to come back in one week--another $200.

Do you see? The care is approaching $1000, actually with the prescription pain medication and hand cream, would have been $1000. Instead, because we are paying the bill ourselves, the bill is around $500. And our son's hand is healing pefectly fine.

Yes, we are doctors ourselves, so feel more confident evaluating the healing process. But that's just the point. For other people it might well be worth their money to get the follow up care because they lack expertise.

For example, when we go to the car dealership, we have to pay for a lot of care that other people might not because they know how to fix it. We don't. Likewise, a lawyer might not have to pay for law advice because she knows it. Or a grocer can skim old produce off the shelf because it will go to waste anyway and he'll save money.

When it comes to cash, people are more willing to deal, too. No patient who needs care but can't afford care gets overlooked in our practice. Thousands of dollars of care gets given away every year in our practice and in doctor's offices (especially the independent ones--the big hospital-affiliated practices don't give as much away because billing is separated from the one giving the service--the doctor) across the USA. And that is as it's should be. We are in a helping profession. We like to help.

I am loathe, however, to see corporate patients with rich health care benefits while their insurance cuts my fees to nothing. In some cases, we go behind financially with insurance covered patients who could more than pay for their care! That is an uneven exchange. The patients are numbed by their relationship with the Insurance Company. They no longer see themselves as consumers. They see themselves as beneficiaries and get angry when they actually get billed for services not covered by their insurance. Newsflash! Why should doctors be expected to work for free? More than many other professions, we have HUGE costs to operate our business. I don't even like to add up our insurance coverage (doctors are big targets), money we spend on accountants (IRS likes doctors too), and then there are our fat college loans.

Cash, which forces a direct doctor-patient (service provider-consumer) relationship, solves this. Doctors can cut fees at their discretion. Patients have to explain to their service provider directly why they can't pay. Doctors can choose to give extra services. Doctors can give the care they believe the patient needs. Doctors can spend the time they would like to understand the problem.

What about high-cost treatments? Well, you know what, a lot of treatments are bunk, but insurance pays them. Consumers would get smarter. Episiotomies? That $400 procedure has absolutely no medical benefit, but it is done all the time. Caesareans? No, "elective" procedures should ever be covered. There is too much risk. But insurance pays them. Blood thinners with Angioplasty? Actually make outcomes worse. But insurance pays it. Angioplasty itself? Not effective one year out, but insurance pays it. Knee surgery? Back surgery? Bunk and bunk. Done all the time and insurance pays it.

Why does insurance pay this stuff? Heck if I know! Why do patients submit to these ridiculous, painful, unhelpful procedures? Mostly becuase they have the s%#t scared out of them and "Something MUST BE DONE". Bah! So many patients would rather have a sexy surgery, than exercise, change their diet or do the very unsexy work to get back to health--because they wrongly believe the "procedure" will save them time and money (because the hard work stuff isn't paid for by insurance). Which it doesn't.

Our practice is full of post-surgery pain-filled people who are as bad off or worse than before their procedure. That's why we call our office a RESORT--the last resort. Frustrated, embaressed, the patients are willing to try anything to get back to their old way when "standard practices" and "procedures" fail them.

That is not to say Modern Medicine fails everyone. On the contrary, patients need surgeons to cut out bad stuff, emergency medicine in emergencies and high-tech diagnostic procedures to catch bad stuff before it gets really, really bad. That costs money. A lot of money.

The high-deductible insurance is a good choice. Consumers will have to decide if the problem their facing rises to the level of serious monitary investment. No? Maybe they dodge a bullet and the problem goes away. Yes? Maybe they pay money for nothing. Yes? Maybe they catch a life-threatening problem.

Patients know. They might be in denial, but they know, often intuitively, when something is not good. Doctors are notoriously wrong when it comes to knowing how much worry to invest in a patient's symptoms. This is proven as more and more care is dictated by computers because they are less wrong than human doctors! (Heart attack signs are better evaluated by a complex computer algorhythm than people. It's true. The computer ignores all the doctor's biases. Even really good doctors.)

Let the patients decide. They have to live with the results anyway. When costs come down because patients take their health into their own hands, the result may be that more employers pay for the high-deductible plans. It's a nice BENEFIT.

Insurance is not an obligation of the government or big business. It just creates a further class divide. Health care payment is the obligation of individuals. Everyone needs to remember this as their insurance coverage dwindles.

The country will be a better place when insurance companies diminish and the consumers take charge again.

Contain Health Care Costs, Pay Cash

Dr. Sanity pointed me to a piece by John Stossel about controlling health care costs by putting the consumer and the service provider in contact. In essence, by paying cash, patients cut out the big, bloated, fat, obnoxious middle man--the insurance company.

Over the years, our practice has morphed from 80% insurance to now about 5%, and I'm eager to get rid of that 5%. Insurance companies' reason for existence is not to facilitate a patient's health. Their existence is to make money. And do they ever! I've written about this before as you all know. This is what a cash-based doctor must do:

He has to compete for his patients' business. One result of that is lower prices. And while the procedure got cheaper, it also got better. Today's lasers are faster and more precise.

Prices have fallen and quality has risen in other medical fields where most people pay for care themselves, like cosmetic surgery. Consumer power works -- even in medicine.

Here's another thing: cash offices aren't always the cheapest. Ours isn't. In fact, those with insurance can go to a myriad of doctors offices and receive cheaper services. More power to them! But they can't get the services we provide at our office. So while some doctors are being assaulted by the insurance company--trapped in a situation where reimbursement is embarrassingly inadequate but fearful the patients will bail if they give up that company--we are charging fair fees. The fees may make some people decide not to come in, but that's okay with us. Our patients chose our care, get better faster, and ultimately spend less money. And, we don't feel taken advantage of because we're being paid less than a Value Meal at McDonalds for our care. (One company reimbursed $5 of the fee with the patient paying a $5 co-pay. It cost more to bill the insurance company.)

If the medical profession were more cash-based, paying attention to the doctor's track record would matter a lot more. The guys who are bad surgeons or physicians would be more exposed. They wouldn't be able to hide in group practices and bury their dismal statistics. Likewise, excellent doctors, doctors who seem to have the magic touch could charge higher fees. And why not? They have better outcomes and are better skilled.

Many professions where the care seems voluntary like dental, chiropractic, cosmetic, eye surgery have changed to be primarily cash. It's a win-win for patients and doctors. The relationship is more pure. Doctors are more responsive. (Yes, we get calls at night and on weekends at times.) Patients heal faster. They are an active participant in their own healing. The stakes are high--they pay more if they don't follow the doc's instructions. When it's out-of-pocket, people are very motivated.

What about the poor people, you ask. Well, we've never turned anyone away for financial reasons. We have a specific percentage of our practice that is charity. Most doctors do the same. In addition, old-fashioned bartering can fill the bill, too. I know doctors who've been paid in blueberry pies. There's worse ways to be paid.

Stossel concludes:

When consumers pay for medicine themselves, saving insurance for the big things, and doctors deal directly with consumers, doctors begin to compete. They start posting prices and work to keep them low.

And consumers gain more control of their health care. Instead of governments and insurance companies deciding for patients, patients decide.

Competition gives consumers more choices. And choice gives them power. Remember that when you hear a politician promise to make health case accessible and affordable through the force of government.

Absolutely. Getting cash back into the whole endeavor would create a cheaper, more honest system. When my son burned his hand and we took a trip to the hospital, since our insurance is high-deductible, it was all out of pocket. The hospital and doctor over-billed. With insurance, it would never have been questioned. Why would the consumer care? They're not paying (oh, but they are, just not right then). But my husband talked with both offices and got the bill re-coded. He has a great motivation to keep the institution and doctor honest: it's his money. Every patient would do well to hold their health care providers accountable--insured or not.

Dr. Sanity said, "The free market? What a concept!" In medicine, it's a foreign one, but one that doctors and patients should become reacquainted with. The alternatives are frightening.

Solving the Illegal Immigration Problem

I live in Texas and Texas has lots of illegal Mexican immigrants fueling the booming economy with cheap labor. I say "cheap" and mean that they are getting paid what the job deserves and combined, families make enough money to live and live rather well. Houston has one of the cheapest housing markets in America mostly because it's unregulated. Contrast Texas with California and you'll see the difference. I don't know how illegals fare in California.

Houston, like other cities with thousands of immigrants, suffers under the weight of the illegal immigrant burden. The health care system is suffocated with those who cannot or will not pay. A friend was outraged when he went to the hospital after getting in a crash and the people who had been in the accident with him checked in at the same time. They had no money and no insurance and they got treatment while he got out his wallet to pay his hefty deductible. He said to the insurance person, "Hey, I want to say I have no insurance."

"I'm sorry sir, but you already gave me your information, I have to show that you have insurance." My husband and I have a $6,000 deductible. We're self-employed (you know, rich doctors) and our inflated insurance premiums and billing subsidize the uninsured.

And then there is the imported "mind set". I have many Mexican friends and they all bemoan it, but it's a reality nonetheless. Mexican society is not a merit-based society but a family and classist society. One reason the Mexican government doesn't want the border stopped up is that the angry, unemployed (because of corruption) underclass would mutiny ala Venezuela. The U.S. government doesn't want this either. It would be a bad thing to have a civil war on our Southern border. The other problem, more insidious and less obvious, is that mind-set filters through here. It is impossible, for example, to get a job at the local Wal-Mart Distribution Center without a familial, Mexican, connection. It's a long story about why I know this, suffice it to say, I know. There is one employee there who "screens" all job candidates and guess what happens if he doesn't like the potential employee? The Mexican system isn't merit-based, it's relationship based. And yes, I am not so naive as to think that this kind of thing doesn't go on everywhere, but in the American system, nepotism has limits--it's called a board or there are rules.

The workers compensation and personal injury lawyers in Houston are fed clients through a family business (or rather a couple of family businesses) that are hispanic. The lawyers and doctors fed those patients are very deferential to these women. Very deferential. The families have the power to make and kill businesses and the doctors and lawyers know it. The patients are fed to certain doctors who will diagnose the right kind of injury to get the most money out of the insurance companies. Another way insurance rates goes up.

And then there is the unfairness educationally. An Anglo competes with lesser educated children of immigrants for spots in colleges. While I am no way in favor of an uneducated underclass, the notion of fairness in such a high-stakes enterprise as college illustrates the unintended costs of illegal immigration. Children of illegal immigrants are minorities and as such, are granted special favor in subsidized education. A friend's (now legal but started illegally) child has a full ride to college. And she didn't pay taxes on her house keeping business either.

To say that there would be humanitarian woe should all illegals be rounded up and sent back to Mexico is an understatement. Can this be averted? Yes, but this is a secondary question, really, and a red herring. It is a problem that doesn't need to be solved right now. The first problem is stopping the flow of workers from south of the border so we don't have this continuing "humanitarian crisis" in the future. But for economic and social reasons, Congress and the President have no intention of creating a secure border. The United States electorate would experience inflation again with a tight border. It's simple, really. Less workers, higher wages, businesses struggle to keep costs down, prices passed on to the consumer, rinse, repeat.

Once the illegal flow from Mexico is stopped (picking off drug runners armed to the teeth would be a nice start), the question of digestible immigration can resume. It is the height of folly to bring in a socialistic mind-set, subsidize it and then want it to discontinue magically somehow. The solution is an immigration system like when Ellis Island was active. It is almost miraculous when you go there and see how thousands of people were processed every single day. We need to do the same thing again. There is no question America needs more workers. What we need are engineers. America still draws the best and brightest from around the world. We need to make it easier to do legally.

Once the border is blocked and a more seamless legal immigration program is enacted, then we can talk about how best to help the illegal immigrants here intigrate into society. Whole parts of California acting as Little Mexico is anathema to me. What are we as a country without a culture, language, laws, and borders? We cease to exist.

For a differing point of view, The Anchoress.

Update: Does anyone believe for a minute that illegal immigrants won't continue to pour over the Rio Grande even after this sweeping legislation? Please. This is not a real solution. This is appeasement. As a political issue, I still maintain this topic hurts Democrats more. This issue is not a problem that only those on the extreme left and extreme right care about. At least, I don't consider myself extreme. I don't want the families involved hurt. I want the problem solved in the future. Passing out biometric cards will only interest law-abiding Mexicans, which, when it comes illegal immigration is an oxy-moron, isn't it?

Doping Kids And Your Tax Dollars Pays For It

Would it concern you to know that nearly one out of 100 teenage boys is on anti-psychotic medication and one out of 150 girls is on anti-psychotics? From the Wall Street Journal:

Medco found prevalence of kids taking antipsychotic drugs, once called major tranquilizers, roughly doubled, with about 1.2% of boys and 0.75% of girls taking them in 2006.

Widely used antipsychotic drugs -- including Risperdal, Zyprexa, Seroquel and Clozaril -- are approved for treating schizophrenia and bipolar disorder in adults, but not children.

Dr. Insel said the drugs often are prescribed for kids for disruptive behavior and other unapproved uses, particularly to children previously on antidepressants and ADHD drugs.

A federal survey of doctors' office practices estimated a sixfold jump from 1993 to 2002 in patients aged 20 or younger prescribed antipsychotic drugs, to 1.224 million. It found 38% of those prescriptions were for disruptive behavior such as ADHD, 32% were for mood disorders including depression, 17% were for developmental disorders such as mental retardation and autism, and 14% were for psychotic disorders such as schizophrenia.

Meanwhile, Medco found use of prescription sleeping pills nearly doubled, to about 0.3% of boys and 0.44% of girls.

"The fact that these kids have to get a prescription pill to go to sleep at night is amazing," said Dr. Robert Epstein, Medco's chief medical official, adding parents should try slowing kids down at night with curfews on caffeine and computer use, for example.

He said Medco's numbers reflect drug use among adolescents covered by private or government insurance, but in general children in the Medicaid program use more prescription medications and those with no insurance take significantly less.

So, 70% of teens taking an anti-psychotic do so because they feel sad or they act bad--not because the have a concrete diagnosis. And kids on sleeping pills? Are these doctors demanding that the kids knock off the Red Bulls, or just as likely, the Ritalin or other amphetamines so popular these days?

Now, for the Medicaid users. There are those who would say that the uninsured are under medicated--you know Risperdal deficiencies that are so prevalent these days, but it's funny how people who don't have insurance don't take the meds. I'm also curious about standard insurance med usage rates. Are Medicaid users, are poor people, more likely to be mentally ill or is the fall-back position of stressed parents and inflexible school bureaucracies, medication? Whether there is discrimination or whether human nature looks for the easy way out, these numbers are profoundly disturbing.

Caesareans Cause Insurance Problems

The vast majority of Caesarean sections are unnecessary, invasive surgeries. To add insult to injury, many women are finding themselves un-insurable after a Caesarean. Insurance companies don't want to cover women of child-bearing age. Period. It's expensive and the insurance company's goal is to make money. The insurance company's goal is not to make sure you get well. That is your job. The doctor's job is to help you.

It is helpful to remember these roles when you're making health care decisions.

Government Health Care Doesn't Work: See the VA

Part of war funding is preventative (missle shields), active (combat troops and equipment), passive (military bases, technology, R&D) and post-combat (wounded, reassimilation, etc.). It seems to me that America has been so out of practice and so defunded militarily that parts and pieces of all these aspects of war readiness have been ignored. It is especially egregious to know that Vets from all wars receive sub-standard and mismanaged care, but truly there hasn't been the funding or stream-lining of beaurocracy (an oxymoron if I've ever written one) to efficiently help Vets.

Still, it is important to remember that beaurocracies in general are uncaring beasts. Private doctors know the frustration of dealing with insurance companies, as do patients, trying to get care they need. At least with private insurance, there is some recourse. A vet has no recourse, really, with the government--except through elected officials. The Washington Post finds a disgruntled Vet who says:

"Once we can no longer be utilized as a soldier, we are of no use to them," said Michael Foley, 52, a former Navy intelligence specialist who served in Vietnam and Cyprus during the 1970s. "There is an impression of indifference when you are dealing with the VA benefits people. They are going to get a paycheck no matter what."

I don't believe the first part at all. All branches of the government do care, but are rather impotent to do anything about it without being irresponsible with the taxpayer dollar. The second part of his concern is true. With insurance workers and claims advisors (doctors who couldn't make it in real practice) detatched from their client's plight, what difference does it make?

I remember a story about a patient who pulled a gun on a doctor because his Workers Comp benefits didn't come fast enough and he was about to lose his home. He was in pain, out of money, absolutely hysterical and didn't know who to blame. Like any institution, the government is very efficient at taking in money, but not so efficient in disbursing it. And citizens have little recourse.

The solution is not more government. The solution is private industry. At least there would be some accountability.

Altenative Therapies: UK "Eminant Physicians" Call It Hocus Pocus

Alternative Medicine in the UK is being debated as a subset of Socialized Medicine. The debate there is more intense because the government pays for everything. Traditional medical doctors are irritated that their fine services are even debated with Alternative Medicine. Why, Alternative Medicine is bunk, pure and simple. The lack of research proves it. The research that exists is sub-par. The gold standard of research is double blind studies. The gold standard for drug companies: medicines that can be patented.

Alternative Medicine will probably never enjoy the same religious standing as the hallowed halls of Medicine (at least with Medical Doctors). The approach is radically different. The difficulty with most Alternative Medicines? Double-blind studies are difficult (ever tried a pretend needle? or sham adjustment?). The results can't be patented. Since vitamins and minerals and herbs are food, they can't be patented. No money to be made. No research conducted.

While plenty of Traditional Medicine Docs hate Alternative Medicine in the U.S., they have a rougher time of it with patients, because the patients disregard their opinions and pay cash to see their Chiropractor, Acupuncturist, Massage Therapist, Naturopath or even Energy Healer. That makes it even worse! These other practitioners get cash while MDs are slaves to the government health care system and insurance. And if you think slavery is too strong a word, you haven't been in the double bind of wanting to help a patient, get paid nothing for it and having care managed by some pointy headed accountant or undereducated nurse somewhere.

What patients want is results. While traditional docs may loathe the touchy-feely, lack-of-stats treatments that many enjoy (much of it traditional medicine, btw), as long as people get results, they'll pay.

The great thing about being an Alternative Doctor is that I know, my husband knows, that if we don't produce results, people won't come back. We can't rely on guaranteed payments--insurance companies are very unkind to Chiropractors. The government is even worse. There is no insurance equality--that is, other practitioners get paid more for doing the exact same thing even though we have as much, and in some cases more education in the area.

Oh well... Life is tough all over. We help people. People get better and refer their friends. And people pay cash because they've tried all the stuff that should work and doesn't. Medical professionals and even some Alternative Docs swoon over statistics and double-blind studies. Most people are interested in what works. Clinical results are valid, too, even if they are only anecdotal.

While there is no shortage of people benefitting from and/or enduring drugs and surgery (traditional medicine has job security), there is also no shortage of peopld benefitting from and/or enduring alternatives. Why must Medical professionals insist upon their way or the highway? It couldn't possibly be market competition, could it? Nah.... It couldn't be that.

Money Wasted on Unneeded Tests

Many unneccesary medical tests get order wasting millions in insurance, and ultimately, your money. Here's why:

1. Doctors are no longer well versed in physical exams and use testing to diagnose (they should be used to confirm diagnosis).
2. Doctors go on fishing expeditions when they can't figure the problem out and end up with lots of unuseful tests.
3. Doctors get sued for missing something and so over-test to cover their arses.
4. Patients demand testing not realizing more mundane methods work as well or better than the latest greatest test.
5. Doctors and patients like testing--it's a gadget and it's fun.
6. Doctors get paid to interpret testing. Their buddies get paid for doing testing. They sometimes have a financial stake in testing.
7. Insurance companies pay for testing. They don't pay for more time with and thorough physical exams. This encourages testing and discourages time with the doctor.

Those are just a few reasons for testing overuse. The main problem is that consumers are shielded from the costs through insurance. If people had to pay fee for service, the best doctors, the best diagnosticians, would be in business and do very well. Patients would not be interested in spending $1500 for an unneccesary MRI when a $50 X-ray, or simple palpation would do. But patients/consumers are removed from costs so they are like kids in a candy store with medical testing. Doctors do little to discourage this because they fear being sued. Denying a patient his desired test and then finding out bad news makes for messy lawsuits.

In the end, no one is really happy. The high deductible plans will help change the system because people will be shelling out their hard earned dollars to pay for services. You can bet with the Internet and access to research, the consumers will be more educated and not so free with the greenbacks when they pay themselves. It's worked that way for our family.

Thadeus McCotter on Fixing Health Care in America

Who is Thaddeus McCotter? He's the House Republican Policy Committee Chairman. Here's what he said to John Hawkins (read the whole interview, lots of good stuff):

We need to get a patient centered -- not a bureaucrat centered -- version of modern medicine that allows a patient/provider relationship to be the key and to build upon that. That, to me, is going to allow the supply to meet the demand to the point where costs start to come down and adequate safeguards are there for those that cannot help themselves.

I think this is key, too. And to get a patient-centered relationship, you need to return power to the people in the relationship.

Imagine for a moment, that you are in a relationship with a guy, but that all dating times, conversation topics and every other part of your relationship was managed by a company who didn't know you, didn't particularly care if the relationship works or not, and actually hoped the relationship ended. That's what insurance companies are like. The government is even worse.

The energy exchanged while dating is love, or the potential for love. The energy exchanged in a doctor-patient relationship is knowledge and expertise for money. When a third party enters this relationship, the dynamics change. The patient takes things they don't need. The doctor gives things they don't need, or maybe that are inferior because the third party demands it.

A cash-driven relationship keeps the exchange more honest. George Bush was actually on the right track when he wanted to expand Medical Savings Accounts. It put the power back in the hands of those in the relationship. Of course, insurance companies do NOT want this. And the government itself loses power when people have more power.

Right now, the relationship is bureaucrat-centered and the bureaucrats would like it to stay that way.

Pharmacists Have Had It, Too

The web is full of all sorts of intelligent, um, incisive people. The Angry Pharmacist is my new favorite. Here's what he says about Medicaid users on Clomid (the drug that forces your ovaries to pop multiple eggs thus increasing your chance of pregnancy):

That sounds pretty much like welfare to me.

I dont know where you got the bum idea. Obviously you are so ignorant that you walk around with a Medicaid chip on your shoulder looking for a fight. The whole rant you were complaining about was that Medicaid patients (who you say are "dissabled and on ssi or welfare or medicaid") should not be entitled to fertility drugs. So am I mean for making a legit point? Or are you just an idiot for wanting to bring children into this world that you self-proclaim you cannot afford.

I'm not against having children (unless you're 14, more on that later), just not while you require society's dime to survive. I guess common sense like that is why I'm a pharmacist and you aren't.

My favorite post so far, though, is about Heather, The Human Shield. Heather is the poor dear fronting for Insurance companies looking to screw doctors and patients. Here's the Angry Pharmacist's take:

So it pains me to be upset when I hear Heather's voice on the other end. I know its not her fault that her employer is retarded, or that the wrong ID number got printed on the card. I know that if she ran the world everything would probably work smoothly. Shes there to pay her rent and buy herself food. She is probably going to college or basically cant get a job anywhere else. Here we are screaming at them for something that they have absolutely no control over just to vent our frustration. Are we any better than those asshole doctors who scream at us because expensive-drug-x is $900?

So next time you're all fired up about WellCare not having the right ID number, and you hear Healthers voice on the other end, think of this post and realize that its not Heathers fault. She's there to do a job much like you are and probably goes home and rags on pharmacists like I ran on Drug Reps.

(Yeah, I realize this post isn't full of hate, bad words, sexual talk or anything like that. It just sorta struck a nerve that I'm sure lives deep down within all pharmacists. I'll try better next time. Fuck insurance companies and drug reps..There.. All better.. :-) )

Everyone loves their pharmacist, but pharmacists are people, too.


H/T Instapundit

Nuclear Bunkers Back in Vogue

You know, I'm just wondering if it isn't time to explore nuclear bunkers here in the United States. They are doing it in Israel:

AMID mounting fears that Iran is planning to obliterate their country, wealthy Israelis are shelling out on underground nuclear shelters in the gardens of their luxury homes.

The shelters, which cost at least £60,000 for a bargain-basement version, are built to withstand radioactive fallout, have fortified walls and doors and generate their own electricity and decontaminated air. Defence experts estimate that hundreds of such bunkers, many fitted with all modern conveniences such as bedrooms, kitchens and bathrooms, have already been built in private homes across the country and demand is soaring.

I'm reading the book Standing with Israel by David Brog, and he notes a Netherlands (I think) family who saved over 700 Jews by building a safe room, escape in their house years before Hitler rose to power. Actually the future Furer was sitting in a prison cell, but this family saw the writing on the wall. They paid for their foresight with their lives when they were finally caught, but before then, they saved many lives.

The Mormons, members of the Church of Latter Day Saints (they oppose the term "Mormons", but it is a description most people recognize), plan for a dire future in a myriad of ways--stocked up food, survivalist training, etc.

After the hurricanes, it became patently obvious to me that my family is soft. We don't hunt. We don't have survival equipment. We don't have much of anything that would save our hide in a time of need.

The time to have flood insurance isn't when a flood comes. The time to have flood insurance is before hand. The Israelis rightly distrust their government's ability to protect them. Can we Americans trust our government? I think we're better served if we don't.

So, when do we build the bunker?

Hippa Works....Too Well

In the category Stupid American Legislation, Hippa has to be one of the worst laws ever. As with all paths to hell, it started with good intentions:

1. People should have access to their records
2. People should not fear being discriminated against when changing employers
3. People should expect that their records are private

This legislation achieved these goals and much, much more. Doctors, terrified of liability and running afoul of the Feds, restrict information gathering of governmental agencies, families and other doctors causing mounds of frustration.

Imagine: A law intended to make information private actually makes it private.

The New York Times reports that doctors haven't fully educated themselves about Hippa. Really? Every doctor I know was completely freaked out by the legislation. Doctors read up on and informed themselves to the best of their ability, but as the Time's writers report, even experts disagree about the rules. Stupid rules like literally locking patient files away rather than having them in open shelving in a locked office were recommendations at seminars and articles.

New reams of patient disclosures are a must. The fist full of legalese from within the Texas Children's system is laughable. Even the college-educated can't be expected to understand the rules when signing them. It's ridiculous.

Now, the same moob who wrote the legislation wants to fix its problems, by (you guessed it) a new group of bureaucrats:

Senator Edward M. Kennedy, Democrat of Massachusetts, a sponsor of the original insurance portability law, was dismayed by the “bizarre hodgepodge” of regulations layered onto it, several staff members said, and by the department’s failure to provide “adequate guidance on what is and is not barred by the law.” To that end, Mr. Kennedy, along with Senator Patrick M. Leahy, Democrat of Vermont, plans to introduce legislation creating an office within the Department of Health and Human Services dedicated to interpreting and enforcing medical privacy.

“In this electronic era it is essential to safeguard the privacy of medical records while insuring our privacy laws do not stifle the flow of information fundamental to effective health care,” Mr. Kennedy said.

This spring, the department revised its Web site, www.hhs.gov/ocr/hipaa, in the interest of clarity. But Hipaa continues to baffle even the experts.

That'll do the trick. More dim-witted middle men to muddy the waters. As if doctors and patients don't have enough grief dealing with the uneducated plebes working in insurance companies deciding patient care. What this new agency will do is find ways to persecute doctors they feel are in non-compliance with some arcane detail.

No bureaucracy in history ever was created to send awards out to those who are doing their best to comply.

And don't forget who is really suffering: the patients. Family are denied access to information. Patients are denied advocacy.

This law needs to be scrapped, but it won't be. Parents, don't let your children grow up to be doctors.

Mitt Romney on Glenn and Helen--UPDATE

Update: Why was Romney talking to Glenn & Helen to begin with? Betsy has the answer here.

Here's what she says of the "New Media" way of dealing with this political flare-up:
It's up to you whether or not you think that Romney has indeed changed his view or if he's just a political opportunist. You can decide of it even matters what his views on these subjects are. What I think is neat is how both the pro and anti-Romney folks were able to conduct this debate on the Internet within one day's news cycle.

The old-time media was reduced to covering the new media the next day. For example, the Boston Globe is basically reduced to giving the transcripts of the two videos.

This is how politics is going to be conducted from now on and any campaign that isn't ready to jump on these new media techniques and use them will be left in the cold. Or at least that is true as long as sites like YouTube can stay working!

This puts in mind a question Ann Althouse asked yesterday about the influence of the blogosphere on the '08 Presidential election. My answer was essentially "not much". Perhaps I was being too pessimistic. Another blogger noted that it will matter more in the Primaries, Romney said this himself, but in the general election Walter Cronkite rules. I cannot tell you how much that dismays me. Unless Walter and his cronies are caught in a bold-faced lie by the New Media, the New Media doesn't matter much. Mostly, we preach to the converted.

Update II: Ace says "meh". I agree with him on this:

The governing class, no matter what their stated politics, comes out of the same coastal monied class that all good liberal twacks do. That rubs off some.

Voters want their leaders to strongly embrace their particular values, and care about them strongly, but each voter has a different set of priorities he needs his leader to unswervingly support. Meaning that we have politicians who are supposed to care about everything passionately.

We have a word for people who care about everything passionately. We call them "maniacs."

I know this is going to sound crazy to some, but abortion is NOT a deciding issue for me. That's why I can vote for a Guiliani. Will he walk the line? Will he pop this bloated pig of a government? That's what I care about. Ultimately each person will have to answer for a decision like abortion. Ideological purists should find a campus from which to teach and speak, or a church from which to preach. Same thing.

**********************

Whilst I put my Amazon Store together (please take a look and comment below), I listened to Glenn and Helen talk to Mitt Romney. I must admit I was totally impressed. Different readers have told me that he's right on the issues and a good leader, but he's not on the national scene and I don't watch TV anyway so I hadn't seen or heard him, well ever.

He seemed concerned about all the things I'm concerned about: War on Terror (he already is forming a plan), Research and Development (what makes America great), Medical research (he articulated his position perfectly--he's for stem cell research, but doesn't want to to "create embryos to kill them"), Gay Marriage (he's against it, but he's for all people being respected and loves gay people and has them working for him--GOOD!!).

Here's my absolute favorite thing he said, "People worry about Universal Health Care. We already have Universal Health Care. Right now there are people who have insurance and then there is everyone else who go to the Emergency Room and get care which is paid for by those who have insurance." (This is a rough translation.) He is absolutely right. Today you and I pay for the illegal immigrants and those who don't have health care. In fact, if I wasn't worried about my credit rating going through the dumper, I'd just say "Forget it, let someone else pay."

Anyway, listen to the whole thing. It's a thoughtful interview and you learn a lot more about this guy. I think he articulates the Conservative message well. In fact, he seemed to me, to most represent a moderately American point of view. I give him huge bonus points for living and working in a nearly socialist state. He must work and play well with others. Of course, so did Bush in Texas, but this being Texas, even the Democrats are more conservative. More than that, Washington D.C. is a pit of poisonous vipers and the most amenable person can be painted extreme.

That last part leads to the following question: Who, in their right mind, would WANT to become President? That's the first question he answers.

Keeping Focus On The True Messiah

Well, folks, I'm going to depart from politics for a moment. For my blog readers, that's not a surprise. Lately, all I've been doing is departing from politics. For John's readers, if you haven't visited my blog, it will be a little different.

The church bells ring behind me as I sit on my friend's porch. Beyond the bell tower, I see the gulf where the sun peeks through the clouds as I listen to Ode to Joy. It is a beautiful, meaningful day for Christians around the world. My friend's children exulted in Easter baskets and delighted in found treasures. It has been magical watching another family revel in their tradition.

Holidays are a nice time to slow down, take stock and refocus on what is truly important. Some things in life are so transient and fleeting. The concept of eternity, living forever, puts the temporal in perspective. We aren't here for long and what consumes us day to day often matters little in the big scheme of things.

Now, that concept is something that bothers unbelievers mightily. They feel that belief in God makes a person lazy both in thought and action. It excuses "sin" and forgives sloth. A Christian won't reach his potential because he will wait for God's will. A Christian loses his will when he surrenders to God.

A Christian knows this is not true. A Christian is freed from having to control everything. A Christian controls what is in his power to control and has faith that God is in charge taking care of the rest. Far from absolving a person of responsibility, the Christian feels moved to do more with what he has because he has been given so much.

Okay, so maybe I will talk politics for a minute. The Messianic obsession this election cycle, the live-or-die nature of the attachment to the candidates (on the Left, does anyone feel super passionate about McCain? I think blah feelings is what you get when you're a moderate) reveals a true lack of faith generally. People look to people or people look to government which is just a bunch of people to do what people used to have faith that God would take care of.

Most of us have been recipients of Christian charity at some point in our lives. I know I have. When my sons were in the hospital and every day was a financial struggle, a church I used to attend sent me $5,000. No strings attached. They gave it in faith. And I used it in faith. It paid for food, parking, rent, everything I couldn't afford while I was at the hospital. It was humbling. It was a bit embarrassing. I had never relied on anyone for anything and it was almost more than I could bear needing it so badly. It pricked my pride.

In contrast, when my son came out of the hospital we had no insurance. We were poor by any measure. He was 4 pounds 6 ounces, we were heading into the winter season and one bout of a common cold (RSV) could kill him. I sucked up my pride once again and went to the Welfare office. After hours waiting, I talked to a very kind social worker who understood my plight but explained that we didn't qualify because our car was too new (we needed a newer car, because our old one couldn't make the trip to downtown reliably and we didn't want the car to die with me in it with a tiny, sick baby). You do qualify for food stamps, the man told me. I hung my head. No. Way. There is no way I'd go to the store and buy my food with food stamps, baby or no. I'd starve first. I politely declined and marveled at the horror and humiliation of the whole experience.

Now, you might think that I cursed the government for their arcane rules where someone barely making it couldn't qualify to have a sick child covered. That wasn't my reaction. I decided then and there that we'd have to make more money and we'd find insurance one way or another and that I would never, ever, ever step foot in a government agency that way again. It was one of the most demeaning experiences of my life.

The contrast was real. The church people gave and had faith in me, but more so in God. It wasn't about me. It was about laying up treasure. And they weren't doing it to make brownie points for the afterlife (and if they were, they've had their reward), they were helping from a place of love. The government workers had tied hands. They had rules. They had limitations. They had to be wary of scammers. They were jaded, and understandably so. Had I been more wily, I suppose I could have gamed the system. I could have lied about the car. I could have put things in other people's names. There were all sorts of things people did to comply, but at what cost to the dignity of the individual and to the fabric of society as a whole?

Believing in a man or a woman, like the Hillary and Obama zealots do, is bound to be disappointing. They are human, fallible, selfish, people. They aren't God. Today is a good day to remember who God is and who God isn't. Only one person in history rose from the dead giving hope of a perfect government to the world and that person isn't [Update: oops! I saw the error but my internet connection in Florida lacked power] running in this election.

Cross-posted at Right Wing News.

Mental Illness In Children: Survey Reveals Adult Skepticism

Do you believe children are overdiagnosed as hyperactive?
	Yes
	No
pollcode.com free polls

New research about mental health and kids shows a skeptical public, but the study's author feels that the skepticism is unjustified:

"The results show that people believe children will be affected negatively if they receive treatment for mental health problems," says study author Bernice Pescosolido, director of the Indiana Consortium for Mental Health Services Research, in Bloomington.

Let's see: you can't serve in the military, many job's rightfully explore the job-seeker's mental health and a person who has suffered with mental illness since childhood would likely be excluded from a job, insurance rates would be higher (those with mental health issues use all health care services more) and the list goes on and on. It is deeply disingenuous of the doctors and psychologists to imply that there are no negative side affects from seeking mental health services (and claiming so on insurance).

Also disingenuous is this statement:

Normalizing these conditions would help too, Quinn says.

"We need to view depression and ADHD like we do allergies," she says. "They are very treatable."

No, mental illness is not "very treatable". In fact, depression is very difficult to treat both in children and adults. In addition, many of the treatments have nary a study to document efficacy. There is so much unsubstantiated garbage passing as fact in the profession, that parents are often misled about treatments. (For more on this, read Destructive Trends in Mental Health--links below.)

Here are the results of the survey of 1300 American adults:

•85% of those interviewed believed that doctors overmedicate children with depression and ADHD and that drugs have long-term harm on a child's development. More than half believed that psychiatric medications "turn kids into zombies."

•40% of respondents thought children with depression would be dangerous to others; 31% believed children with ADHD would pose a danger.

•45% said rejection at school is likely if a child goes for treatment, and 43% believe that the stigma associated with seeking treatment would follow them into adulthood.

These results seem perfectly reasonable and rational to me.

Happy kids don't look for their parent's handguns, now do they? Happy kids don't commit suicide. Happy kids don't pick on other kids. Happy kids don't kill cats or otherwise torture animals. Happy kids don't self-mutilate. There are a whole host of things happy kids don't do that depressed kids do.

I don't know if the study's authors have been in a Special Ed room lately, but the behavior kids invariably are diagnosed with ADHD and on some sort of medication. In my son's class, Mr. ADHD was the one who attacked the teacher. Of course, not all hyper children are violent. And most hyper children shouldn't be on Ritalin either. The fact that 90% of all the Ritalin in the world is taken by United States children should be a cause for concern among the mental health profession like it is the vast majority of American parents. Strangely, save for a few, most give out these stimulants more freely than your corner drug dealer.

This survey just proves to me how out-of-touch the mental health profession is with the real world. Reasonable people just don't buy the professions pathologizing of normal kid behavior. Not to mention, this generation still remembers how effective a well-timed, and deserved, good whack on the rear was for reducing hyperactivity. A miracle cure. Instead, every out-of-control parent with every out-of-control child looks for medication to manage behavior.

In rare instances, there is a biophysiological reason for the problem, but my experience has been that diet changes and other life-style changes can go a long way to help most kids. Save the medication for the seriously disturbed children.

There would be more empathy for mental illness, if it didn't seem like everyone, and so many children, were categorized as mentally ill these days.

Health Care Costs Soar & Government Can't Pay Bills

For years now, people have wrung their hands about health care in America and nothing has been done. The reason for this is simple: the consumers are detached from the product so typical market constraints are removed that exist in a free-market system.

Troubling times for local governments abound because of long-term pension costs. And what will have to be deprived to feed the beast? Education, public safety and public works will all be cut back on. Notice that pension benefits won't be cut.

Health care is a mess. Insurance pays for diagnostic testing patients don't need and pays for treatments that have no evidence to support the benefits. Insurance won't pay for testing not considered to be "standard of care" and won't cover procedures that cost less and accomplish more.

The potential for intergenerational war to break out as entitled Baby Boomers get sick and decline (Yes, even they will die. I know, it's shocking.) is worrisome, to say the least.

HPV Vaccine Mandatory in Texas--UPDATED SCROLL DOWN

Today, Texas became the first state to mandate the HPV vaccination for girls. My peeved mom called today and asked my opinion. My first instinct is to dislike it because of the way Governor Rick Perry handled the issue--by executive order. Republicans here are NOT happy:

Several key Republican lawmakers lashed out Monday at Gov. Rick Perry's edict requiring anticancer vaccines for all Texas schoolgirls and vowed to derail the plan before it takes effect.

State Sen. Jane Nelson urged Perry to rescind the order and said she will ask Attorney General Greg Abbott to rule on its legality. Three other Republican lawmakers filed bills that would override the mandate and several others were working on similar legislation.

"The public has the right to testify on this issue and the Legislature has the constitutional duty to be involved in this decision," said Nelson, who chairs the Senate's house and human services committee.

Also Online

WFAA-TV's Brad Hawkins reports

Perry defended his decision, saying his fellow conservatives were wrong to worry that mandating the vaccine will trample parents' rights and promote premarital sex.

Here are the facts:

• Human Papilloma Virus is a sexually transmitted disease.
• Nearly all Cervical cancer is caused by various strains of HPV.
• The new Gardasil vaccine protects women from the strain of HPV that causes 70% of cervical cancers. From their website:

  GARDASIL is the only vaccine that may help guard against diseases that are caused by human papillomavirus (HPV) Types 6, 11, 16, and 18:
  •	Cervical cancer
  •	Cervical abnormalities that can sometimes lead to cervical cancer
  •	Genital warts
  HPV Types 16 and 18 cause 70% of cervical cancer cases, and HPV Types 6 and 11 cause 90% of genital warts cases.

• The HPV vaccine is not a guarantee of cervical cancer avoidance, it reduces a woman's risk of cancer.
• 80% of women have HPV by age 50.
• If a woman remains sexually inactive she has a 0% chance of getting any strain of genital forms of HPV.
• The NIH recommends that girls get vaccinated at age 12. The website says for women ages 9-26.
  

There is resistance to the vaccine in some parts:

David Catania, a Washington, D.C., City Council member, says there's a simple reason [for wanting to make the vaccine mandatory]— protection against cervical cancer.

"For 14,000 women per year it means cervical cancer, and for 4,000 it means death," he said. "The district has a particular reason why this is important. It is important because we lead the nation in cases of cervical cancer. We have the highest instances of cervical cancer in the country."

But as in most states where there have been proposals to require the vaccine, Catania had to take a lot of heat. A local newspaper columnist worried that the measure suggests girls in the District of Columbia's public schools — most of whom are African American — are sexually promiscuous. Catania insists that the legislation doesn't target any particular group and the vaccination wouldn't exactly be mandatory.

The newspaper columnist reveals political correctness run amok. If D.C. has the highest rates of HPV infections, I would suggest that the girls there are promiscuous. Don't worry, though. Girls, black and white, are promiscuous or have steady sexual partner everywhere these days, so it isn't racial motivated to recommend the vaccine. Nearly 70% of girls have had sex by age 18.

I have reservations about this vaccine for a couple reason:

1. What 9 year old is/should be sexually active?
2. This vaccine is being marketed like it's a magic pill. The reason for this is market-driven not health-driven.
   
3. How are the longitudinal safety studies? I'm a skeptic about these things. I view all new treatments like I view the new Vista operating system--with reservation. New technology takes a while to get the bugs out. Medical treatments, including vaccines, do, too.
   
4. Where do parents rights/states rights begin? This is perhaps the most important issue for me. I'm not alone in this concern. The government has progressively gotten more intrusive when it comes to vaccination and health in general. I don't like this road we're on. Will the state require genetic modification (or will insurance companies?) when that becomes available for diseases like heart disease or other forms of cancer?

And here is a long-term question: Will insurance companies refuse to give treatment to a woman who refused a vaccine and then gets the cancer? That hasn't happened thus far with smoking, but premiums are certainly affected.

The LA Times discusses some other ethical concerns:

The debate highlights the balance between government's obligation to safeguard the health of its people and the rights of individuals to make their own decisions about matters affecting their health and their children's health.

All vaccine mandates pose this dilemma. But the question of an HPV vaccine presents more medical and ethical wrinkles.

"School-based laws began in the 19th century, at about the same time as mandatory education laws," says James Colgrove, a medical historian at the Columbia University Mailman School of Public Health who recently wrote an article for the New England Journal of Medicine about the ethics and politics of HPV vaccination. "People realized that schools were breeding grounds for illness." [this is still true, by the way-ed.]

Because HPV is not spread through the germ incubator of the classroom, a mandatory vaccine would lack that rationale. Further, for the first time, vaccination policies would affect only one gender. "With a compulsory HPV vaccination, we really are kind of getting into a different territory," Colgrove says.

Some libertarians like Glenn Reynolds are for this vaccine and would even include it in childhood vaccinations. He is dismissive of the science those in the alternative health profession, like chiropractors (I am a chiropractor), claim undermines vaccination benefits.

I am wary of vaccines due to personal experience. I nearly died of anaphylactic shock reaction to the Measles part of the MMR vaccine as an infant. I had successfully been vaccinated for small pox--the public should be happy that I won't be a vector for that...or shouldn't be if it works (many vaccinations efficacy wane with time). My husband was fully vaccinated but was one of the hundreds that year that received a "bad" batch which resulted in these people thinking they had immunity, but they did not. He ended up with mumps as a teenager (along with his teenage brothers). He ended up with Measles as an adult and ended up giving that to my son (who wasn't immunized due to the family history of anyphalactic shock). So, there you go. (My son was okay, by the way. I nurse all my kids for 18 months to two years and they receive passive immunity this way. A child's immune system does not fully mature until age two.)

I have reasons to be very grateful to drug manufacturers. Glenn Reynolds does, too. His wife lives because of a hi-tech pacemaker and an exotic pharmaceutical. My son, born at 24 weeks gestation, received Bovine surfactant (Surfican) that saved his little life. (Unfortunately his twin died by being infected with a hospital-borne strain of Methicillin Resistant StaphylococcusAureus [MRSA] .) Without these surfactant and powerful antibiotics, my surviving son would have died, too.

I have reasons to be skeptical of drug manufacturers. There is a constant push to increase markets for medicines that are untested for that use. This is call off-label usage. Children are being medicated with drugs that have never been tested on them. Ditto vaccinations. Children are walking experiments. There has yet to be one randomized, controlled study for the efficacy of the Hep B vaccination in children and yet they are given this vaccination at birth. The studies that were done were conducted on young men. Why? Because young men are at the highest risk for the Hep B due to homosexual activity and I.V. drug use. Psychotropic medicines are given to young children--ages two and three--with not one randomized controlled trial.

Then there are the medications that did have full trials and were found much later to be worse than the disease they were purportedly treating. These include COX-2 inhibitors (a class of anti-inflamatories) and Hormone Replacement Therapy. Stroke, cardiac arrest, heart disease and cancer were the unfortunate side-effects but were only found years down the road.

Now we come to a vaccination that will only be used on women, young women, and for a disease that can be prevented (like Hepatitis B) behaviorally. Again, from the LA Times,

Proponents of mandatory vaccination are invoking the philosophy of utilitarianism, the notion that decisions should be made to provide the greatest good for the greatest number of people, Zimmerman says. That philosophy, he says, can be used to justify all sorts of ethically suspect behavior. Although he plans to have his daughter vaccinated against HPV, he says he should not be coerced to do so.

"HPV is not caught by sitting next to someone in class but by sexual contact, which often is a lifestyle choice," he says. "Using school laws, which were developed to protect children from communicable diseases like smallpox and measles, to mandate vaccination against a sexually transmitted infection, is to use the ends to justify the means."

As for other vaccine mandates, such as those for measles or whooping cough, Zimmerman says that other ethical principles justify those requirements — notably the notions of beneficence (doing good) and nonmaleficence (doing no harm), Zimmerman says. "If a person who is unvaccinated brings measles or pertussis [whooping cough] to school, their mere presence can lead to harm to other children," particularly to those children who cannot receive the vaccine for medical reasons.

While I don't want one more woman to die from cervical cancer, I don't want the government to mandate one more invasive rule, either. There is an unholy alliance between the FDA, drug manufacturers and the government--especially for vaccines. (Vaccine manufacturers get the benefit of not being liable for any side-effects secondary to their vaccines. Isn't that great? Even if they manufacture vaccines overseas, they are contaminated or worthless...no liability.) I understand how expensive it is to bring a drug to trial. I have talked before about potential solutions to the problem. In short, I think people are oversold solutions and then shocked when the "solution" doesn't work with his or her body chemistry. All interventions need to be viewed with caution--and medicines, including vaccinations are interventions.

Another thing: while vaccinations have been tested individually, the results of the substantially increased number of vaccinations at one time have not been tested. Of course, one could point to the millions of kids walking around as evidence that they don't have a deleterious effect. My personal experience suggests otherwise.

Taken together, I think all people, not just parents, should be concerned about the aggressive "it's for your own good" stance the government has progressively taken. Between eminent domain, the IRS and the local health department, citizen's rights continue to erode. For those worried about wire-tapping (and I actually view the NSA program to be for the public good), state-mandated HPV vaccination is just one more way the government controls your life and mine.

Here are some resources:

• Nice one page summary of vaccination (Australia, but chosen for clarity).
• Website information skeptical of vaccination and here, too.

UPDATE:

Wouldn't you know, the last thing before bed, I go looking at Anchoress and she has fantastic links on this issue. Why am I surprised? You absolutely must read these resources, too.

Happy Catholic says this about encouraging young people to have sex by making STDs seemingly unimportant:

A good friend challenged me on some of the material and also was surprised that one of the reasons I didn't like the idea of the vaccine was the possibility of the effect on adolescents' tendency to have sex (as mentioned in the excerpt above).

I guess I should have qualified it more ... mostly because I hear through Hannah and Rose how much misinformation they are told by friends "is absolutely true" and most of the time it is about half-true if that.

So I looked at this and thought of the girls who come into their freshman year of high school pregnant because "everybody knows" that you can't get pregnant when you're on the pill or using condoms or without full penetration ... or whatever the myth is that they've been told. And this just looked like a silver bullet for people to start saying that it works on all STDs.

Here's an important point I didn't mention via Evil Slutopia (you know us crazy chiropractors, we're conspiracy nuts and all):

While we're on the subject of liability, lawsuits, and profits, there's another angle to consider. If Merck can get state governments to put Gardasil on their lists of vaccines that are required for schoolchildren, it can become a part of a federal vaccine liability program. Meaning that Merck will not be liable if Gardasil turns out to be harmful some time in the future. [5] [6] [7]

If I felt like being cynical again, I might think that this is one of the reasons why a vaccine for a sexually transmitted disease is being marketed not just to young women who are having sex or are going to become sexually active soon, but also to girls as young as nine. There’s a hell of a lot more stability and profitability in a required childhood vaccine than there would be in an optional vaccine meant only for young women.

It's important to remember that no matter how many feel-good, we're all in this fight together and we're just doing this out of the goodness of our hearts ad campaigns they run, drug companies are not non-profit organizations. They are in this to make money and a lot of it, and while that doesn't mean that all prescription drugs are harmful and horrible or that all doctors are evil, it does mean that when it comes to our health, we probably shouldn't take anything at face value.

Evil also brings up the sexism of only giving women and girls this vaccine (this is longish but worth it):

I think both men and women can take issue with this. Men, because their sexual health is really not being addressed here. They don't even have a test that can tell them whether they have HPV or not, so even if they want to be responsible about it there is only so much they can do. And women, because they are being asked to take full responsibility for HPV prevention. Women and girls are expected to take on all of the costs and the risks of this vaccine, and even if they do get vaccinated they could still be infected with HPV by a male partner who has been told that HPV isn't something that he needs to worry about.

From the Centers for Disease Control and Prevention website:

"There is no clear health benefit to knowing you have this virus—since HPV is unlikely to affect your health and cannot be treated. For most men, there would be no need to treat HPV, even if treatment were available— since it usually goes away on its own." [18]

Isn't it a little irresponsible (and sexist) to say there is no benefit to a male HPV test? Regardless of the possible health issues such as penile or anal cancer, isn't not infecting your unsuspecting partner also considered a benefit? Men are reassured that tests and treatment are unnecessary because their HPV infections will likely go away on their own, while the fact is that most women's HPV infections will go away on their own as well. [19]

Apparently, when Gardasil went before an FDA panel for approval, Merck asked the panel to approve the vaccine for boys also, even though they have not done the same amount of testing on boys as they have on girls.

"Merck asked the committee to endorse vaccination of boys age 9 to 15, too. Urging them not to wait for ongoing studies to end, it said evidence shows Gardasil can prevent some male cancers and may slow the spread of sexually transmitted HPV.
'By delaying three-plus years, we could have an additional 100,000 [cancer] cases that could have otherwise been avoided,' Barr told the committee. But panel members didn't vote on the request, calling the idea compelling but unproven."[20]

It seems to me that we need to spend more time researching HPV in men and boys, not less time. And it would be nice to feel like Merck was taking this issue seriously and not just tacking it on as a "me too" measure in order to get approval more quickly. On the flip side, it's a positive step that more research on HPV in men is now being done. Maybe they'll even change their minds and decide that it is worthwhile to develop a male HPV test after all. They could probably share a lab with the researchers who are hard at work on that male birth control pill we've been hearing about for years.

This vaccine was fast-tracked, if state-sponsored Merck avoids liability, it's a behaviorally avoidable disease, and it's only for girls. To top it all off, the government can mandate this. No choice.

There are many very logical, ethical, moral, and health reasons to avoid this vaccine.

Hurricane Dean

OK, Brendan Loy is freaking me out. Actually, I had a feeling that last summer wouldn't be a big deal, storm-wise, and talking to a girlfriend this summer I said, "I don't know why, I just have a bad feeling about this summer. Like we're going to have a bunch of storms." She said the same thing and we both bought flood insurance even though neither of us live in a flood plain. We'll see if that was a wise choice or not. Brendan is concerned:

With regard to the official forecast track, and the age-old “line” vs. “cone” debate, Dr. Jeff Masters says that at least in the short term (i.e., the next 48 hours), we’re safe focusing more on the “line” and less on the “cone”:

The cone of uncertainty Friday morning, when Dean is expected to pass through the islands, covers a wide stretch of ocean from Grenada to Antigua. We can expect that this uncertainty cone is too wide, since the steering currents are relatively stable right now and Dean is well-formed. This puts the islands of Martinique, Dominica, and Guadaloupe in the bulls-eye.

As an aside, I’d love to see the NHC start tailoring its “track cones,” or “cones of uncertainty” — whatever you want to call them — to the actual level of uncertainty for each individual storm, instead of relying purely on historical error rates. There is no question that some forecasts can be relied upon with more confidence than others, depending on computer-model agreement, steering-pattern stability, and so forth. Yet judging from the NHC’s graphics, you’d think that all track projections are created equal. Moreover, sometimes the NHC will choose to place the official forecast track in the left or right portion of the “guidance envelope”; when they do this, shouldn’t the uncertainty cone be fatter on one side than on the other? Yet it never is. I’d love to see this change.

Sounds like it would be a helpful change. Also, I think I'm going to go look at generators again. And I'm going to post these recommendations from Glenn about disaster survival. He notes:

DISASTER PREPAREDNESS UPDATE:

Most people along the Gulf and Atlantic coasts haven't made hurricane survival plans, despite pleas from emergency officials for residents to prepare before the season starts, according to a poll released Thursday. . . .

One forecaster said odds were high that a major hurricane would hit the U.S. this year.

Nevertheless, 53% of people surveyed in 18 Atlantic and Gulf Coast states say they don't feel that they are vulnerable to a hurricane, or to related tornadoes and flooding, according to the Mason-Dixon poll. Eighty-eight percent said they had not taken any steps to fortify their homes.

Of all his links, my favorite is Popular Mechanic's list (I have some work to do myself):

Basic Emergency Kit
Gather these into a portable, free-standing container such as a large plastic tub:
• Charged cellphone (and a 12-volt cellphone charger for your car).
• Three-day quantity of food, 1 gal. of water per person per day, disposable cups, plates and eating utensils, and a means to cook, such as a camp stove with sufficient fuel.
• Sanitary supplies for three days.
• Nonscented liquid chlorine bleach.
• Rain gear.
• Work gloves.
• Multitool.
• First-aid kit and first-aid manual.
• Battery-powered flashlight.
• Battery-powered radio.
• Spare batteries.
• Light sticks.
• Filtration mask (NIOSH-N95).
• Plastic sheeting.
• Duct tape.
• Whistle.
• Can opener.
• Garbage bags and ties.
• String or twine.
• Paper pad and pencil.
• Printout of key phone numbers.
• Five-day supply of prescription medications

And for your car:

Keep in Your Vehicle
Keep these in a plastic tub:
•Road flares, reflectors.
• 12-volt cellphone charger.
• 50 ft. of nylon cord.
• Heavy-duty plastic tarp.
• Jumper cables.
• One-day supply of food, such as energy bars, and water.
• Flashlight.
• Sand for traction in snow and on ice.
• Folding entrenching shovel.
• Emergency blanket in cold climates.
• 3 gal. of potable water in hot climates.
• Multitool.
• First-aid kit.
• Fire extinguisher.
• Tire inflator/sealant.
• Duct tape.

I bought the hand-crank radio, a chain saw, a first aid kit, a bowie knife, a multitool, rope and some other things. One thing to check: some of our food was so old. I found this out the hard way cooking with some evaporated milk. It does go bad, even in a can.

Finally, the really big concern for Houstonians is our wet ground from all the early summer rain. The current tropical storms passing through making everything wetter and then having a hurricane dump on the wet ground and pull up loose trees, etc. That would be bad, to say the least.

Atheism Is Like So Totally Intellectual

I would feel so much smarter just being able to say,"I'm an atheist. What are you people? Some no-necked, bucket-eared, God-fearing simpletons, that's what. If only you were reasonable." It's delightfully easy being an atheist and so smugly satisfying. So, Christopher Hitchens the atheist debated Mark Roberts about God. Here's what James Lileks said and I'm still giggling:

Related: Hugh Hewitt had a three-hour debate between Hitchens and Mark D. Roberts the other night over the subject of God, and it was quite enjoyable, both for its depth and civility. I think Hitch won, ergo God Does Not Exist. Dynamite the churches! Of course, in such situations the atheist always wins, because he doesn’t have to prove anything. It’s like a color-blind man debating someone without sight about the existence of Red – a fascinating intellectual exercise that tests and reveals the talents and character of the debaters, but has little to do with the hue of the stuff that runs through your arteries.

Well, I think the RC church let Cicero into heaven as a noble pagan, so Hitchens needn't despair. Although he'll have to spend the first 9 billion millenia drinking tea with Mother Theresa.

Oh, and Mr. Lileks is gainfully employed and, it seems, happier, too. He's all the "buzz" and here's a sample from over there:

Google has decided – on a lark, just for grins – to digitize every book in the world and put them online. Even those romance novels whose covers have Fabio pirates with pectoral muscles the size of serving platters. They’ll provide the books for free, of course. Google does everything for free, yet has a market value of $937 trillion dollars (approximately.) Google, as we speak, is driving cars around major cities taking pictures; you’ll be able to view street-level views of all big towns online. Next year I expect they’ll buy everyone’s DNA and put that online, followed by digitized versions of your nightly dreams, acted out by student theatre troupes and uploaded to Google Video so everyone can check out your roiling subconscious. Google always gets kudos for its motto, “don’t be evil.” Well, that’s special, but it’s like telling your kid “don’t eat the cookie.” Your kid wants the cookie, after all. Does Google want to be evil?

Jovial mood, don't you think? He's bouncing along on the I've-still-got-insurance feeling. Yippee!

Why Populism Rings True Right Now

Huckabee's rise and the success on the left of all the big three candidates (and their seeming dead heat and similar message) brings populism front and center. For democracy to work in America and in successful nations around the world, there needs to be a sense of fairness. Opportunities need to be available to everyone and there needs to be a sense of safety. This last issue has grown as people have taken on the entitlement attitude. They expect social security. They expect Medicare. They expect drug benefits. And with the medical-insurance problems and the threat of economic woe should a person have a health issue, American citizens expect the government to fix it. And by "fix", I mean that someone else should pay for their problems. Oh, and the economy can never go into a recession, because that will cause problems, too.

Conservatives have ignored this strain within the party. The true believers--anti-abortion, anti-gay marriage, evangelicals--are not necessarily small-government libertarians. (And this type of thing incenses them.) George Bush recognizes this fact, I think, which is why he pushed through the No Child Left Behind bill and the Prescription Drug Benefit. That's his definition of compassionate conservatism.

Huckabee gets this and I think the other candidates ignore this streak in the party to their own peril. There must be some answers to why small government is important. And there must be some answers for the middle class who feel squeezed and one check away from disaster. They might not like the answers, but their difficulties need to be acknowledged. (Of course, if Huckabee's out, then the others can keep pounding their personal messages.)

And then there's the environment. I know this sounds strange, but I've said before and I'll say it again: there are many on the conservative side who feel the environment is an important issue. Like abolition and equal rights, stewardship of the earth is a Christian issue. Some of the most ardent recyclers are Christians motivated to "dress and keep" the earth. They are zealous and dedicated.

In order for the Republican candidates to resonate with these constituents, they're going to have to recognize who's voting for them. Ignoring issues that matter to voters is never a good idea. And while a Rudy Giuliani or Mitt Romney may do well in the general election, these guys have to appeal to a complex base first. It's not all God and guns and it's not all small government and tax breaks in the Republican party.

Truly, the Republican party is a big, diverse tent, far more so than the Democrats. The Democrats just want a Democrat in office at this point--Hillary, Obama or Edwards would all do nicely. They're the same person just in different colors, shapes and clothes. But the Republican part has grown more diverse as time has gone on. That partly explains the diversity of the candidates.

The candidate who wins on the Republican side will be the one who appeals to the diverse many. I think they all need to tweak their messages.