Wednesday, July 29, 2009

Dear Hank,
July 29, 2009
Health Care in America, Obama wants to kill you, Socialized Medicine and other fairy tales

Recently, a friend asked me to look at an email he had gotten that said Obama wanted to pay for his plan by killing older citizens.
We didn’t think it could be true.
I found the bill that was being referred to and found that what the bill was providing for was a way to help people get a living will and a durable power of attorney and advice about hospice and other end of life options.
Here’s a link to the bill:
http://waysandmeans.house.gov/media/pdf/111/aahca09001xml.pdf
You can go to page 425 and read for yourself.

Yesterday, Obama was asked this question in an AARP town hall meeting. Here's his answer:
http://bulletin.aarp.org/yourhealth/policy/articles/obama_fields_tough_questions_on_health_care_reforms_at_aarp_tele_town_hall.html

His answer to the lady’s question was what we suspected and confirmed - that trying to have people get a living will was a good idea.
Bear in mind that this bill is one of several that congress is looking at and it's not "Obama's bill." He told congress what he wants in a bill and is letting them do their job to craft one.
Why would someone want the government to try and get people to have living wills?
In two words "Terri Schiavo"
Let's take this on a more personal level. While discussing this one relative said that if he were in that situation, “Just pull the plug.” My friend said you didn't like the government telling him what to do.
Let's say Mr. “Just Pull the Plug” goes unconscious tomorrow and efforts to revive him fail. During that time of trying to revive him he is put on a ventilator and a feeding tube. After a period of time, say five years, it is determined that he is in a persistent vegetative state and in the opinion of the doctors and his family will never come out of that state. We all heard his wishes - pull the plug. Would anyone be allowed to do that? I think the answer is, "no." Not without getting a court order, etc. If you have a living will your wishes are known and written down. That's not to say you couldn't say, "keep me alive at all costs," you could. But without a living will the government will tell you what to do. (ie Keep him alive.)
Then there is the question of who pays for all this care - and it won't be cheap. I figure $5-20,000 a week.
In the case of Terri Schiavo her husband spent all his money and devoted years to taking care of her. Ultimately, it pitted him against her parents. Why? because she didn't have a living will.

Here's the case and a snippet I copied from the Wikopedia article:


http://en.wikipedia.org/wiki/Terri_Schiavo_case

Michael did not directly make the ultimate decision about whether Terri should live or die: he petitioned the court, asking it to act as Terri's surrogate and determine what she would decide to do if she were able. Schiavo's husband insisted that she had expressed her wishes not to be kept on life support with no hope for improvement. During a trial in 2000, testimony was heard from witnesses on both sides to establish Schiavo's wishes regarding life support. The court determined that she had made "credible and reliable" statements that she would not want to be "kept alive on a machine," based on expert testimony, finding that Americans do not want to live "with no hope of improvement," and that her condition in a persistent vegetative state had "long since satisfied" the requirement that there be no hope of improvement.


Okay, let's move on to the issue of socialized medicine, one of the big bug-a-boos of many on this issue. Typical arguments are:
I don't want the government making decisions for me,
I don't want socialized medicine,
I don't want my choices limited,
Look at Canada and England with their long lines and you have to wait so long to get treatment.
The government can't run a health care system as well as private industry can. They'll gum it up with red tape and it will cost more.

There are more arguments I'm sure.
But many of the people making these arguments are on Medicare. Medicare is a government run health care system. That means Medicare is socialized medicine (socialized means when the government runs it.) If you don't like Medicare go to a private provider. Why don't people do that? Because Medicare is cheaper and better than the private systems. People wait til they qualify to get on Medicare before they take care of certain things.
Let's look at another government run health care system The Veterans Administration, the VA. The VA gets consistently high marks in every health care category you can find. It outperforms private systems and is cheaper. It's is better and cheaper. If you want evidence talk to a veteran who uses the VA. The VA was not always this way. I remember when it was a terrible system (back in the 60's I think.)
Remember when they got a new administrator who made the patient records electronic and streamlined procedures? Some of the reasons given for why the VA is so good is the centralized electronic records so a patient can go to any VA hospital and their records are immediately available. This eliminates duplicate tests for example. Another reason is that their is an incentive to make people well because the VA has these people for life. There are many other reasons.
Interestingly, William Krystal admitted the other night on The Daily Show with Jon Stewart that the VA was excellent health care (and that our soldiers deserved it but we as citizens don't. We, private citizens, had to have private health care.) Here's the clip:
http://www.casttv.com/video/ofbb2p1/jon-stewart-interviewed-bill-krystal-video
I'm sure there are some that will say he was tricked. But in this age of taking things out of context: the wise Latina comment and the Obama wants to kill you; being the latest two I can't say that Mr. Krystal can really cry about being tricked (not that he and others won't claim it.)

And let's not forget that the really best health care system in the world is enjoyed by our people in congress - another socialized system.

In fact I would say that the three best medical systems in the U.S. are the three I named above. All socialized medicine. They are cheaper and better run then any private system in our country.

What makes them cheaper? They don't have to pay marketing and executive salaries. They have power to negotiate prices. They are in it for the long haul with their patients, as opposed to private systems where patients have to reup every year. And let’s not forget that private health care is “for profit” health care; any money paid out is a loss in profit. Therefore, it is in the insurance company’s interest to deny benefits whenever possible.

What about the Canadian and English system comparisons? The systems being proposed here aren't close to those in Canada and England. Most people in those countries are very happy with their systems. Care is not limited, nor are there the long waits that are being reported by some. Are there problems? I'm sure, but not anything compared to our system. I remember years ago articles about problems in the English system. But whatever problems they have had seemed to be fixed. I know that in our current system I can find articles any day of the week that report how people have been denied care by their insurance company.
Also, interestingly there was an article several years ago that said British doctors were much better at diagnosing a problem using a stethoscope than American doctors. Why? American doctors are so afraid of getting sued that they order every conceivable test, costing the patient hundreds of dollars even when 99% of the time they could have diagnosed it with a stethoscope. American doctors no longer depend on the stethoscope; they can’t afford to. Btw – A gynecologist in Maryland told a patient that one of the reasons for her high bills was to cover her insurance - one million dollars a to protect herself from lawsuits.
Here on Hatteras Island not a month goes by where their isn't a fund raiser to help someone who doesn't have health care. Why don't they have health care? Is it due to lack of choices as so many have yelled about if a government option was put in place (that reasoning is beyond me. If the government offers another option how dose that limit your choices?)

Now I ask you and you can ask your friends what alternatives have others have come up with?
The health care and pharmaceutical industries say everything is fine "don't get squeezed", "enough is enough" say their TV ads.
We currently have the most expensive and worst health care system in the industrialized world. Should we leave bad enough alone?
Currently, the lobbying effort by the health care industry works out to $1.3 million a day on Capital Hill.
The Republicans have not put forward any health care bill. They are planning to spend $1 million this August during the recess to fight health care reform. This does not count what the health care, insurance, and pharmaceutical industries will pony up.
One Republican congress man has said that if they can stop Obama's health care it will be his Waterloo. So as I see it the Republicans aren't interested in solving the health care problem. They want to tear down anything Obama wants to do, including trying to get better health care for U.S. citizens.

An interesting proposal I heard recently would be to have the public hospitals (that are in dire straights) go on a VA type system and work with the 48 million people who don't have health care. The private health care companies don't want these people. Most of the marketing dollars spent by private companies is to steal patients from other systems (called "sheep stealing" in the religious biz - btw.) Why do it? Why go to such a system? Well, it would be cheaper than having these people go to emergency rooms and it would improve the overall health of our citizens.
I never hear people opposed to any health care plan talk about improving the lives of people. Insurance companies talk about clients and payees - not patients.
Isn't it time to start trying to get people healthy and well cared for in this country? Couldn't we lead in this area rather than tag along behind all the other industrialized nations?

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Monday, July 27, 2009

July 27, 2009

Hank,

Re: New writing method for the kid

Years ago I considered writing SciFi. Every time I came up with an idea I told this buddy of mine who was really big into this kind of stuff. He would laugh and tell me it had already been done. Whatever premise I came up with had already been done. I gave up on the idea.
A month or so ago my old editor at The Black Rock Gazette asked me for a piece for this year's Burning Man. BM's theme this year is evolution. I've thought about what to write and haven't liked any of the ideas I came up with. Yesterday, he asked again and told me the deadline was Saturday.
I decided to try a new technique in developing this story - outlining. Okay, the technique isn't new, but it's new to me in my writing. What I've done in the past is to write and see where it goes. Many authors do this in various ways, typically, they are strongly character driven stories with, usually, an odd, or unbelievable premise. If you can get past the premise the story is often pretty entertaining. Steven King does this a lot. He says he writes to see what his characters are going to do. I've done that kind of writing most of the time and it can be enjoyable but it can also lead to repetition and writing yourself into a corner.
J.K.Rowling said she outlined all the books in the Harry Potter series before she started writing them, at least at a macro level. She also did a more thorough outline for each book before she started writing each one. There was one exception and she said she had to go back an rewrite the last half of that book.
I had already written a small intro piece , but didn't like or know where to go with it. I began my outlining process by writing a one or two line description of each evolution themed idea I could think of. Then I took a second sheet of paper and expanded on each of these themes slightly. This led to a writing of another intro piece in rough form. I also then sketched boxes in horizontal form connected with lines; each box represented one of the pieces I needed to do: an intro independent web piece, 5 - 300 word articles, an ending independent web piece. I had seven boxes labeled. Now I had to figure out what went in each box.
I began writing from my intro thinking about what would come next. I wrote until I understood the guts of the scene and then I moved to the next scene. Interestingly, as I did this a new and unique concept emerged that I had never thought of and I believe (hope) nor has anyone else (Hence, slaying the old SciFi It's already been done dragon.)
If I am right, and no one has done this, then I will have started a new line of thought on the question of evolution and the ethics of some forms of reproduction.
More, later, once I write it all up...

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