Listen Up

Saturday, October 11, 2008

Help us Help them

Don't vote until you see the video

How can we help these people?

Real Stories about Real People

http://www.youtube.com/watch?v=DNHNCScYpX8

Nathan Wilkes

http://www.youtube.com/watch?v=2peGqRrjXek

Cynthia Campbell

http://www.youtube.com/watch?v=McGm00Mvakc

In a stunning turn around, insurance giant CIGNA has capitulated to community demands, and protests that the California Nurses Association/National Nurses Organizing Committee helped to generate, and agreed to a critically needed liver transplant for Nataline Sarkisyan, a 17-year-old girl in the intensive care unit at UCLA Medical Center. Unfortunately, Nataline passed away yesterday just after six o'clock the same day of the massive protest

http://www.youtube.com/watch?v=Wh0mgiwXzGM

Emily Cannon is a young woman in the prime of life, the daughter of a registered nurse, and a former elementary school teacher whose life has ground to a halt since developing a chronic but treatable illness. She is now being denied care she needs to return to the active life she once enjoyed.

http://www.youtube.com/watch?v=K1uXUgTakk4

Watch this compelling video about a mother and daughter living on a fixed income and having to fight their health insurance provider for coverage.

http://www.youtube.com/watch?v=Q4xcV4bULRQ

Retiree Juanita Anderson doesn't just fear the rare disease that attacks her organs and sends her to the ER,she also fears the insurance companies who can change her coverage at any time and destroy her finances.

http://www.youtube.com/watch?v=TqSshZZMHGA

Linda Peeno-Sicko

http://www.youtube.com/watch?v=itKJRq3NU7s

Michael Moore-Sicko

http://www.youtube.com/watch?v=aC7zI7VXcCA

Andy Bales: Rescue Mission

http://www.youtube.com/watch?v=tqmk3ycTmuY

Deborah Burger—RN

Zorses and The Health Train

If you are wondering what a zorse is, check out my other blog

DNA Train & Bill Gates

 

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Arthur Caplan, Ph.D.,a bioethicist at Harvard (2005) espoused a

theoretical scenario regarding Bill Gates.image

"Who needs Bill Gates? No, I don’t mean who needs a gazillionaire corporate titan, a man whose company, Microsoft, took in billions of dollars last year by controlling nearly all the software used to run nearly every computer on the planet.

No, I mean,  literally, who needs him?  If you could go back in time and stop the birth of the world’s most famous nerd, would you?

You probably answered my question with a "no.".......he is the father of a computer revolution that has brought much good to many people throughout the world. Add to that achievement his current generous philanthropic activities supporting some very worthy causes, such as vaccine research and a center for autism research in Seattle, and the case for having Bill with us becomes pretty persuasive.  What if I told you it’s possible that Gates has a medical condition that accounts, in part, for both his tremendous achievements and for his "nerdiness?" Gates is widely reported to display many personality traits characteristic of a condition known as Asperger’s syndromeimage Asperger’s is a mild version of autism, a more serious condition that renders many children unable to talk, be touched, communicate or socialize. While I certainly do not know if Gates has Asperger’s, his difficulties in social settings are nearly as legendary as his genius, so it's possible.  That said, if you had been Gates' potential mom or dad 50 years ago, what would you have done if you knew about his abilities and flaws before he was born?

Asperger’s is the least disabling form of autism and research is beginning to show that it may also account for the presence of some special capabilities in areas like mathematics, computer science and engineering. But the same genes may also create a person who is socially awkward, easily distracted, very introspective and in many ways withdrawn and solitary.

The reason I ask these questions is that there is a good chance we will soon have a genetic test for detecting the risk of autism in an embryo or fetus. The development of such a screening tool raises the possibility that parents might one day have the option of preventing the birth of a child with even a mild case of the disorder.

 

DNA. or desoxynucleic acid was postulated and proven over forty years ago. At that time it was heralded as the next penicillin of health care.

Millions, and perhaps billions of dollars (now worth much less) have been invested in learning more about the molecules of our primordial basis for reproduction.

Recently several high profile biomedical companies have begun to promote wide screening of individuals who appear to be healthy as a predictor for degenerative and/or chronic diseases. Is this technology ready for 'prime time'? Several question have arisen.  The state of California with a recent "cease and desist order"  decided it is not ready, under the present format proposed by the three companies who stand to make a fortune if this idea catches on with the public. (Affymetrix, Navigenics). image image Microsoft seeing a chance to capitalize offers "HealthVault" to store the data for future use by patients and health care providers in this prospective study. 

Will this testing be cost effective, and where is the evidence based "medicine" ??  Will health insurance companies reimburse for this lab test?

"The cost of genetic testing can range from under $100 to more than $2,000, depending on the nature and complexity of the test"

Genetic testing has proven it's worth in predictive pre-natal testing for hereditary chromosomal abnormalities such as trisomy 21, trisomy 18, cystic fibrosis, and other tests not related directly to genetic analysis have predictive value. (Tay-Sachs disease, neural tube defects)

 

A consortium of health care, technology and research leaders have joined forces in a first-of-its-kind research study to assess the behavioral impact of personal genetic testing on people who choose to receive such screenings to identify their potential
risk for developing certain diseases.

    Sponsored by Scripps Translational Science Institute (STSI), and the National Institutes of Health, ie, image image our tax dollars,  the study aims to find out if participating in personal genomic testing will improve health by motivating people to make positive lifestyle changes, such as exercising, eating healthy and quitting smoking, as well as decisions to seek further medical evaluation and preventive strategies. The study will offer genetic scans to up to 10,000  imageemployees, family members and friends of the nonprofit Scripps Health system in San Diego and will assess changes in participants' behaviors over a 20-year period.

    Co-sponsors of the study include Navigenics Inc. of Redwood Shores, Calif.; Affymetrix of Santa Clara, Calif.; and Microsoft Corp. of Redmond, Wash. Study participants age 18 and older can receive a scan of their genome and a detailed analysis of their genetic risk for more than 20 health conditions that may be changed by lifestyle, including diabetes, obesity, heart attack and some forms of cancer. Other companies such as 23andme will offer the range of tests (using a small sample of saliva) for $399.00 through  the internet ( secure)
  

"Genome scans give people considerable information about their DNA and risk of disease, yet questions have been raised if these tests are ready for widespread public use," said Eric J. Topol, M.D., director of STSI and principal investigator of the study. "Our study will prospectively evaluate the effect that state-of-the-art gene scans have on people's lifestyles, behaviors, diets and psyches."

    Affymetrix will scan each participant's genome and Navigenics(TM) will interpret the scan results and offer personalized guidance on steps to lessen the chances of negative health impact. This information will be available to participants on Navigenics' secure Web site. Each participant will be able to enter and store clinical and lifestyle information in an individual image Microsoft HealthVault(TM) image account, allowing the participant to manage his or her personal health information in one location and share it,
as desired, with health care providers or others they trust to help make more informed health care decisions. (ref: PR Newswire)

It's a brave new world out there!!!

 

Friday, October 10, 2008

The Train Station

image Dr Val  www.getbetterhealth.com

Last night I had a chance to join Dr Anonymous on his world famous Thursday evening show. It was great to hook up with fellow bloggers, Dr A, Dr. Val, Dr Rob and many others in the health train station.

For those of you who have not heard, Dr Val has changed 'networks'. Her new blog, which I call  'soft & fluffy' , address is www.getbetterhealth.com   .

Dr Val  has interview posts from Mike Huckabee, Grant Hill, Maria Menounos, Bob Schieffer,Phylicia Rashad, and Dr.

Richard Carmona.

Here is your chance to learn from "Bones" of Star Trek fame. It seems he had troubles with reimbursements as well.

As usual Dr. Val shows her creative flare....this is going to be a great blog and web site...Watch out Oprah and The View..

Congratulations to Dr. Val!!!!  You are no longer homeless.

Dr. L

Thursday, October 9, 2008

Health Train Calclulator


Quote of the day:

Reading is to the mind what exercise is to the body. - Sir Richard Steele

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Located at number 92 in the list of the most popular Health2.0 blogs is 'Stayin Alive'  Clicking on this link takes you to the blog, and in the posting today (October 9,2008) is a link which takes you to the "Health and Education Calculator" .  The web site is self-explanatory. It's a fun thing to tinker around with.

Wealth Train Express

I'll take a right hand turn here (not politically) to share with the readers....we are in the wrong profession.

Some new definitions in the world of business. This guy's blog was bought for  15 million buckaroos!

Revised Financial Terminology for 2008

Johns Wu Posted in Banking News by Johns Wu
October 8, 2008 09:34 AM - 15 Comments

Hat tip to The Big Picture for posting up this bit of Wednesday humor.

CEO –Chief Embezzlement Officer.

CFO– Corporate Fraud Officer.

BULL MARKET — A random market movement causing an investor to mistake himself for a financial genius.

BEAR MARKET — A 6 to 18 month period when the kids get no allowance, the wife gets no jewelry, and the husband gets no sex.

VALUE INVESTING — The art of buying low and selling lower.

P/E RATIO — The percentage of investors wetting their pants as the market keeps crashing.

BROKER — What my broker has made me.

STANDARD & POOR — Your life in a nutshell.

STOCK ANALYST — Idiot who just downgraded your stock.

STOCK SPLIT — When your ex-wife and her lawyer split your assets equally between themselves.

FINANCIAL PLANNER — A guy whose phone has been disconnected.

MARKET CORRECTION — The day after you buy stocks.

CASH FLOW — The movement your money makes as it disappears down the toilet.

YAHOO — What you yell after selling it to some poor sucker for $240 per share.

WINDOWS — What you jump out of when you’re the sucker who bought Yahoo @ $240 per share.

INSTITUTIONAL INVESTOR — Past year investor who’s now locked up in a nuthouse.

PROFIT — An archaic word no longer in use.

I know, I know, we still get our jollies out of helping these people.

Health Train addendum

It seems that no sooner do I ask a question, that the answer appears on other blogs. Thank you Matt Holt, and others.

 

image

 

Candleglance provides some stellar graphics. More comments later.

Answers to the Health Train Questions

Edwin and Kevin, I have found the answer to my questions about symptoms at the  E.D.

From the WSJimage

The grim economy and quaking stock market are driving masters of the financial universe to seek professional help for anxiety, and eroding sense of identity or tips on how to deal with angry clients, the Boston Globe reports.

Therapists are seeing an 15% to 20% uptick in business from affluent clients around Boston, psychologist Jim Grubman told the Globe.

The financial crisis bruises the psyches of the wealthiest in particular because their sense of self can be so focused on making money, therapists say.

“It’s something that I call identity dissolution, their sense of identity dissolves,” Dennis Pearne, another Massachusetts psychologist, told the Globe. “The primary way they defined themselves and who they were and their values - what they can and can’t do in this world - disintegrates.”

In counseling, the rich (or formerly rich) may need to learn that who they are is more than raw purchasing power. Therapy may explore the idea of a different career or, alternatively, how to renew the patient’s motivation to compete again in the market. Grrrrr.

Kick your Apps off the Health Train

I don't know about you, but I have heard, written, and seen about enough of gloom, doom, and problems.  I turn our attention to some fun stuff.

Today we are offering a number of innovative applications to benefit you and your patients.

First, I would like to invite the readers to join an internet site which is a unique central control for all your social networking sites. For those of you who are of an entrepenurial bent, or those who have internet savy and web sites, this is a site with a myriad of tools to promote your web site and integrate it into multiple social networking sites. Kickapps is a user friendly site offering multiple venues for publicizing  your enterprise.  Some of the companies that are represented include: National media, Local media, Blogs, Magazines,Newspapers,Lifestyle,Not for Profit,League and Associates, Community Associations, Local and National Televison, Local and National Radio, NPR.....and more.  There is even a site that will take you to Concierge Medicine.

The site is supported by advertising, and a host of interesting links.  There are multiple tutorials for idiots like me. Exploring this site may give you ideas for your interests. My site gmlevinmd123 is there in it's infancy.  See you there at Kickapps

Warning, this is an unabashedly commercial marketing site.  I make no claims regarding it's veracity and I have no financial interests in the site, nor any of it's participants, other than my own link.

Wednesday, October 8, 2008

Health Train Collision

Harry Truman

"I never did give them hell. I just told the truth, and they thought it was hell."

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The past two weeks have hammered image

all segments of the economy, from the housing markets, banking institutions, small and large businesses, and soon into healthcare.  Unless the credit markets resume functioning very soon we will witness payless paydays in provider groups, elimination of health information technology projects and the abrupt decrease in adoption of EMRs.  The Feds have shot themselves in the foot, quite nicely.

AIG crashed several weeks ago, and we have heard nada from health insurers, their reserves, nor the state of their investments in the market and/or real estate. I am naturally suspicious and it has been eerily quiet from those corners.

Ignoring Crisis has a price  (from the New York Times)

image

After 14 months of crisis, the federal government — meaning you and me — has put serious money on the line. As a point of comparison, the entire annual federal budget is about $3 trillion.

image

Despite everything, the biggest fiscal problem remains, far and away, health care. Based on the rate that medical spending has been rising, the Congressional Budget Office forecasts that Medicare and Medicaid will take up 10 percent of G.D.P. within two decades, up from about 4 percent now. In today’s terms, that would be the equivalent of adding at least $900 billion to the deficit every single year, in perpetuity. It makes the cost of the bailouts look like a rounding error.

When it comes to health care, we have a situation that is blatantly unsustainable. With the right choices, we can prevent that. But so far, we instead seem to be hoping that the situation will magically resolve itself, which is a recipe for big problems and perhaps even a crisis.  Will health care bomb out?

image

Let’s see. That doesn’t sound familiar, does it?

Health Train Track to Reform

Richard Reece, MD in his Medinnovation blog points out that the road to reform is mostly uphill.....Does the road wind up-hill all the way? Yes, to the very end.

“Each of the key players is sharply edged, high-earning physicians, the over-bedded hospital sector, employers squeezed by rapid rising benefit costs, inefficient private health insurance companies, highly profitable pharmaceutical and medical supply companies, and, finally, the public who wants more and better care but doesn’t want to pay for it.”
Sound familiar? It should, for satisfying these stakeholders block the road to health reform today. The road to universal coverage is as uphill as it has ever been.image

 

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Michael L. Millenson, president of Health Quality Advisors LLC in Highland Park, IL, is the author of the critically acclaimed book, Demanding Medical Excellence: Doctors and Accountability in the Information Age.  In the Huffington Post today (a not unbiased publication. Millenson gives his opinion of MCain's plan for health reform

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THCB has an article authored by Maggie Mahar (Maggie Mahar is an award winning journalist and author. A frequent contributor to THCB, she is fellow at the Century Foundation and the author of the increasingly influential HealthBeat blog, one of our favorite health care reads, where this piece first appeared.) She begins her analysis.........

"I have to admit I often have found the language of health care “rights” off-putting.  Yet the idea of health care as a “right” is usually pitted against the idea of health care as a “privilege.” Given that choice, I’ll circle “right” every time."

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The Wall Street Journal  sums up McCain vs. Obama,

McCain said:

I think it’s a responsibility, in this respect, in that we should have available and affordable health care to every American citizen, to every family member. … But government mandates I — I’m always a little nervous about. But it is certainly my responsibili

Obama said:

I think it should be a right for every American. … for my mother to die of cancer at the age of 53 and have to spend the last months of her life in the hospital room arguing with insurance companies because they’re saying that this may be a pre-existing condition and they don’t have to pay her treatment, there’s something fundamentally wrong about that.

The WSJ blog leaves us with this question,

Health Blog Question of the Day: What do you say? Is health care in America a privilege, a right, or a responsibility?

Health Train Derailed

Last night’s debate was rather lackluster and uninspiring. Neither of the candidates revealed themselves to be ‘leaders’ and proponents for a glowing American rebound and future. Neither of them painted a picture of creative thought. Rather it was more like a cabinet meeting of officials discussing nickel-dime instructions on how to rescue our country from decline and mediocrity.

McCain’ plan for health reform made universal payer look highly desirable. He totally ignored the issues of escalating health care cost, the uninsured and underinsured.

He ignored public health, children’s health, and geriatric health and no mention about Medicare reform. There was no mention of the burdens of unnecessary bureaucracy and redundant process.

The idea of removing employers from the equation is a double edged sword. The most negative thing about is that many people would not obtain health insurance if it is not a benefit. Who would pick up the vacuum? The tax credit is inadequate and adds another level of complexity, another attempt to manipulate citizen behavior with more tax codes. It does not address the unemployed, either acutely or chronically. In our present system, employers also analyze health insurance plans and offer a menu of plans analyzed by human resources. Would individuals be able to navigate this morass? On the other hand it removes the employer as a negotiating agent in the marketing war of insurers. Individuals would negotiate directly with the insurers. This would change the playing field.

The campaign has drifted away from ‘the measure of the man’. I tend to like some of Obama’s ideas, but am very uncomfortable with the measure of him. Yes, he did some worthwhile work in Chicago with community development, but where does that work leave the ‘rest of us’.

As in healthcare, the economic rescue plan very much depends on details. Without careful thought and advice from those in the system it will be doomed to failure.

In addition to these factors, the financial world seems to have lost all sense fiduciary responsibility, captivated by profit, greed, and golden parachutes. Many of these ‘captains of industry’ should be indicted for fraud and prosecuted to the full extent of the law.

I and many of my colleagues feel a deep sense of resentment when the financial industry can function in a manner that we cannot. If my medical practice acted in this manner, my doors would be closed. I look at Washington Mutual, Wachovia, and others who have been rescued (for the time being) with open doors, doing business as usual. I think their doors should be shuttered. FDIC can insure the depositors, but these banks should no longer be operating. The employees can work for other financial institutions. However to allow them to keep operating under the same name is a travesty of unbelievable proportions.

It seems harsh, but those who lose money will be much more attentive to the banks with which they do business. Obviously leaving this up to regulators who do not regulate has not worked.

If you have made it down to this point in my diatribe, I will close with the following.

Obviously you and I who have practiced in the system for say 5,10,20 years or more no nothing about healthcare, nor how to reform it (at least that is how the politicians, pundits, and allied personel look at it).

image (from Distractible Mind..thanks)

I am no expert.....that is woefullly apparent from comments I have received from others.  I will pontificate in other areas. Healthcare is in the ICU, intubated, and without  ADVANCE DIRECTIVES. with no means of ''pulling the plug".

image

Medical futility.
Who has the power to decide?

Tuesday, October 7, 2008

Health Train-----I'll catch the next one.

I  am not going to watch tonite's debate. I know all I need to know. In fact I am not going to listen or watch anymore political debates.  There seems to be a total lack of common sense. My criteria for choosing our next President lies in the measure of the candidates.  Listen to Senator Tom Coburn from Oklahoma.

Not their academic prowess

image image image

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Not their marital history....unless it borders on the promiscuous at this time

Not their race or sex

Not their promises

Not their idea of  health care reform

Not their solution for the economic crisis.

I will not base it upon slick oratory, charisma, and/or rhetoric.

 image image

I will base it upon their fundamental belief in all the citizens of the United States.

I will base it upon who paid for their education, and fundamental beliefs in the constitution.

I will base it upon who they 'hang out with'.

 imageimage

image (Photoshop mash up)

I will base it upon to whom they are loyal.

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I will base  it upon their life demonstration to America and thier underlying belief system.

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